Association for Academic Surgery (AAS)

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Educators in Academic Surgery: Who Teaches the Teacher?

When we envision a doctor, we often associate them with being a healer, a community leader, or an advocate. Less commonly, we think of doctors as teachers, even though the very term “doctor” originates from the Latin word “docere,” meaning to teach. Throughout our extensive training, you may recall the limited emphasis on teaching during medical school lectures and the lack of dedicated time to hone our teaching skills during residency. So, the question arises: how and when do we truly learn what makes a good teacher and how do we expect to learn how to excel at it?

As doctors, particularly surgeons, we naturally assume the role of educator in various capacities. We routinely educate patients and many of us also instruct students, residents, and fellows. For some of us, surgical education becomes an integral part of our formal career.  Yet, the development of this vital skill remains a mystery.

What makes a good surgical educator?

Prior work has explored specific qualities embodied by surgical educators,1–4 but there is no clear understanding of what makes a surgical educator effective. In fact, there are only a handful of studies that define or assess what it means to be an effective surgical educator.5 In short, a clear pathway to become an effective educator is virtually absent in the current literature. Therefore, the motivation and decision to engage in surgical education may stem from a personal interest, environmental influence, or both.

What is the motivation to become a surgical educator?

The motivation to be involved in the education field can stem from both external and internal factors. On one hand, external incentives may include adding a valuable line to our CV, fulfilling a job requirement, or meeting criteria outlined in an academic medicine contract. Conversely, internal motivation arises from a profound belief in the power of imparting knowledge. It stems from the conviction that leaving a lasting impact on the next generation is one of the most meaningful contributions we can make, thereby benefiting the greatest number of people. It is thought that these intrinsic qualities play an important role in being a great surgical educator.6

Overall, understanding the essence of being a doctor and an educator redefines the scope of our role in the medical community. Embracing this additional role can not only enrich our own growth but also pave the way for more deliberate educational opportunities in our surgical careers. In this blog post, we will first share opportunities that exist for learning more about surgical education. Then, we will explore a variety of types of educational contributions. Lastly, we will discuss and brainstorm novel and necessary steps to enhance and build upon this current learning model.

How do we learn to be a surgical educator?

National opportunities exist both during training and once in practice. These valuable experiences are predominately sponsored by national surgical organizations, providing opportunities to enhance skills and knowledge. For example, as a surgery resident, you can take advantage of the annual American College of Surgeons (ACS) Residents as Teachers and Leaders course.7 Alternatively, if you are already a faculty member, the ACS has a more extensive course titled Surgeons as Educators.8

The Association for Surgical Education (ASE) also provides two highly-sought after fellowship opportunities (Surgical Education Research Fellowship9 and Surgical Education and Leadership Fellowship10) aimed at fostering proficiency at surgical education research or nurturing strong surgical education leaders, respectively. For those unable to commit to a formal program or those seeking more flexible learning options, the Surgical Education Seminar Series is a good choice. This monthly, free, virtual resource is hosted by both the ASE and Society for Improving Medical and Professional Learning (SIMPL)11 and serves as a convenient option to access expert insight into a variety of surgical education research topics.

What local opportunities could and should exist?

While these national opportunities are undoubtedly enriching, they frequently have limited space available. This leads us to examine what opportunities could, and should, exist locally within our own institutions.  Local surgical education workshops, mentoring programs within and between institutions, and collaborative educational projects are just a few examples of what could be established to complement the broader (and more limited accessibility) national opportunities. Moreover, specialized surgical education journals exist that could bolster local research endeavors. For example, MedEdPORTAL showcases teaching curriculums and their implementation across various medical specialties. However, surgical submissions remain limited and this presents an opportunity for further development. By encouraging and supporting locally-created initiatives, we can foster a more inclusive and accessible learning environment, empowering trainees and surgeons to flourish within their own communities. The integration of such initiatives would undoubtedly contribute to the overall growth and progress of the surgical education field on a larger scale.

How can you document educational contributions?

An Educator’s Portfolio identifies your educational philosophy and houses your educational contributions and achievements. The creation of an educator’s portfolio at any stage in your career will provide self-reflection and allow you to evaluate your education journey. You can continue to build this document similar to building a CV. This portfolio helps you keep track of your accomplishments and allows you to curate your career path. The following list are just some examples of opportunities that may count as ‘educational contributions’.

  • Join national education committees under larger surgical organizations (ex: ASE, ACS, AAS)
  • Join educational administrations (including local/national organizations that support UGME/GME, such as GMEC, HSA, OSR)
  • Give lectures at your institution (for medical students, residents, or fellows)
  • Give invited talks (at other institutions, or local/national conferences)
  • Participate in clinical teaching (to medical students, residents, fellows, and colleagues)
  • Provide mentorship (to medical students, residents, fellows, and colleagues)
  • Provide sponsorship (to medical students, residents, fellows, and colleagues)
  • Participate in professional activities (ex: workshops or research symposiums, oral exams, journal reviewer, or education related research)
  • Work toward leadership opportunities within the education academic track (ex: program director, clerkship director, vice chair or vice dean of education, or other positions within the medical school)

What are the next steps?

The surgical education field continues to grow. This rapid growth is, in part, due to the transition to competency-based training models. As we try to meaningfully engage and contribute to the field, it is important to recognize the limited education training that many of us have. We encourage you to seek out specific opportunities that might be useful to you within the surgical education realm. This might include learning more about how to conduct education research studies, how to provide useful and high-quality feedback to trainees, or learning new innovative teaching methods for adult learners. Collaborative efforts among surgical educators across the country are necessary to continue these important conversations and continue to advance the field forward. We can all play a larger role in contributing to the continued progress of the surgical education field.

 

References:

  1. Dickinson KJ, Bass BL, Pei KY. What embodies an effective surgical educator? A grounded theory analysis of resident opinion. Surgery. 2020;168(4):730-736. doi:10.1016/j.surg.2020.04.056
  2. Swendiman RA, Hoffman DI, Bruce AN, Blinman TA, Nance ML, Chou CM. Qualities and Methods of Highly Effective Surgical Educators: A Grounded Theory Model. J Surg Educ. 2019;76(5):1293-1302. doi:10.1016/j.jsurg.2019.02.011
  3. Dickinson KJ, Bass BL, Pei KY. Medical students’ perception of what embodies an effective surgeon educator. Am J Surg. 2022;223(1):64-70. doi:10.1016/j.amjsurg.2021.07.019
  4. Sutton PA, Beamish AJ, Rashid S, et al. Attributes of excellent surgical trainers: An analysis of outstanding trainers. Int J Surg Lond Engl. 2018;52:371-375. doi:10.1016/j.ijsu.2017.10.007
  5. Dickinson KJ, Bass BL, Pei KY. The Current Evidence for Defining and Assessing Effectiveness of Surgical Educators: A Systematic Review. World J Surg. 2020;44(10):3214-3223. doi:10.1007/s00268-020-05617-9
  6. A master surgical educator: the “intrinsic” factor of Dr. Paul Greig – ClinicalKey. Accessed July 30, 2023. https://www-clinicalkey-com.proxy.lib.umich.edu/#!/content/playContent/1-s2.0-S1365182X22015428?returnurl=null&referrer=null
  7. ACS Residents as Teachers and Leaders. ACS. Accessed July 26, 2023. https://www.facs.org/for-medical-professionals/education/programs/acs-residents-as-teachers-and-leaders/
  8. ACS Surgeons as Educators. ACS. Accessed July 26, 2023. https://www.facs.org/for-medical-professionals/education/programs/acs-surgeons-as-educators/
  9. Surgical Education Research Fellowship Overview. The Association for Surgical Education. Accessed July 27, 2023. https://www.surgicaleducation.com/surgical-education-research-fellowship-overview/
  10. Surgical Education and Leadership Fellowship (SELF). The Association for Surgical Education. Accessed July 27, 2023. https://www.surgicaleducation.com/self/
  11. L’Huillier JC, Moreci R, Gates RS, Thelen AE, George BC, Jung S. The surgical education seminar series: a novel, free resource from the association for surgical education and the society for improving medical professional learning. Glob Surg Educ – J Assoc Surg Educ. 2023;2(1):96. doi:10.1007/s44186-023-00171-z
Rebecca Moreci

Rebecca Moreci

Rebecca Moreci is a general surgery resident at Louisiana State University Health Sciences Center in New Orleans. She is currently a second year surgical education research fellow in the Center for Surgical Training and Research (CSTAR) at the University of Michigan. Her research is primarily on graduate medical education, including trainee assessment and the transition to competency-based training models. She will be returning to residency in July 2024 with plans to apply for pediatric surgery fellowship.
Rebecca Moreci

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Jessica Zagory, MD

Jessica Zagory, MD

Jessica Zagory is an assistant professor of surgery in the Division of Pediatric Surgery at Louisiana State University Health Sciences Center in New Orleans. She also serves as the Assistant Program Director for the general surgery residency.
Jessica Zagory, MD

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