The development of undergraduate curricula in surgery: I. General issues

In-patient operating exposure for dental undergraduates: a valuable experience?

The General Dental Council, the Association of Dental Education in Europe and the Association of British Academic Oral and Maxillofacial Surgeons have all issued syllabuses suggesting undergraduate dental students should gain experience of oral and maxillofacial in-patient operating.Aim To examine whether final year dental students in a UK dental school had observed, and were comfortable providing an explanation of, oral and maxillofacial in-patient operating.Materials and methods Students at Newcastle University's School of Dental Sciences have block allocations to in-patient operating (16 half-day sessions). A questionnaire was distributed to the whole of the final year (n = 78) at the end of these allocations examining different aspects of their exposure to in-patient operating.Results A response rate of 81% (n = 63) was achieved. Those responding reported that they had seen a wide variety of surgery. The most common procedural group that had not been observed was orthognathic surgery (n = 33, 52%). There was no correlation (p >0.05) between total number of procedural groups observed and total number of procedural groups that students were confident to explain, although there were significant correlations (p <0.05) between having observed specific operations and having the confidence to explain them. The students felt that the block allocations were beneficial (n = 46, 63%) and offered a variety of free-text reasons for this. Only a minority (n = 24, 38%) had been actively involved in the surgery they had observed, the majority of those individuals having undertaken some suturing (n = 11).Conclusions Students perceive allocations to oral and maxillofacial in-patient operating as beneficial for a variety of reasons. The relationship between having observed a procedure and the individual's perceived ability to explain it appears to be complex. It is difficult to achieve consistent exposure throughout a large year group of undergraduate students, but more targeted learning may be of benefit.

Integrative vs. Traditional Learning from the Student Perspective

BACKGROUND

The interdisciplinary surgery block of the reformed undergraduate curriculum HeiCuMed includes daily cycles of interactive case-based seminars, problem-based tutorials, case presentation by students, skills and communication training, and bedside teaching. The teaching doctors receive didactic training. In contrast, the previous traditional course was based on lectures with only two weekly hours of bedside teaching. Didactic training was not available.

OBJECTIVE

The present work aims at analysing the importance of active participation of students and the didactic components of the reformed and traditional curricula, which contribute to successful learning as evaluated by the students.

METHOD

Differentiated student evaluations of the undergraduate surgical courses between 1999 and 2008 were examined by correlation and regression analyses.

RESULTS

The evaluation scores for organisation, dedication of the teaching staff, their ability to make lessons interesting and complex topics easily understandable, and the subjective gain of knowledge were significantly better in HeiCuMed than in the traditional curriculum. However, the dependence of knowledge gain on the didactic quality was the same in both curricula. The quality of discussions and the ability of the teaching doctors to promote active student participation were important to the subjective gain of knowledge in both seminars and practical courses of the reformed curriculum as well as for the overall evaluation of the practical courses but not the gain of knowledge in the traditional curriculum.

CONCLUSION

The findings confirm psychological-educational perceptions, that competent implementation of integrative didactical methods is more important to successful teaching and the subjective gain of knowledge than knowledge transfer by traditional classroom teaching.

The teaching of surgery in the undergraduate curriculum--reforms and results

In the past decade, the teaching of surgery in the undergraduate curriculum has undergone considerable changes in quantity, mode and method of delivery. This is a result of the radical reforms of higher education, the health service and the undergraduate medical curriculum. These reforms are often interrelated and are occurring in conjunction with major changes in healthcare delivery. In this article we discuss this reorganisation, the rationale behind it and the impact on surgical teaching.

The teaching of surgery in the undergraduate curriculum – reforms and results

In the past decade, the teaching of surgery in the undergraduate curriculum has undergone considerable changes in quantity, mode and method of delivery. This is a result of the radical reforms of higher education, the health service and the undergraduate medical curriculum. These reforms are often interrelated and are occurring in conjunction with major changes in healthcare delivery. In this article we discuss this reorganisation, the rationale behind it and the impact on surgical teaching.

The surgeon for the future and implications for training

Clinical and technical skill may not be sufficient to fulfil society's expectations of surgeons. Other skills, which have been well defined in the published literature, include those of the professional, communicator, collaborator, manager, scholar and health advocate. It is the purpose of this review to explore the current understanding of these different domains and make comment about ways to improve training that will ensure that the surgeon of the future has the opportunity to develop broader expertize.