Ann Arbor, Mich. From the Section of Plastic Surgery, Department of Surgery, University of Michigan Health System.
Plast Reconstr Surg. 2013 May;131(5):1194-1201. doi: 10.1097/PRS.0b013e318287a0b3.
The traditional method of teaching in surgery is known as "see one, do one, teach one." However, many have argued that this method is no longer applicable, mainly because of concerns for patient safety. The purpose of this article is to show that the basis of the traditional teaching method is still valid in surgical training if it is combined with various adult learning principles.
The authors reviewed literature regarding the history of the formation of the surgical residency program, adult learning principles, mentoring, and medical simulation. The authors provide examples for how these learning techniques can be incorporated into a surgical resident training program.
The surgical residency program created by Dr. William Halsted remained virtually unchanged until recently with reductions in resident work hours and changes to a competency-based training system. Such changes have reduced the teaching time between attending physicians and residents. Learning principles such as experience, observation, thinking, and action and deliberate practice can be used to train residents. Mentoring is also an important aspect in teaching surgical technique. The authors review the different types of simulators-standardized patients, virtual reality applications, and high-fidelity mannequin simulators-and the advantages and disadvantages of using them.
The traditional teaching method of "see one, do one, teach one" in surgical residency programs is simple but still applicable. It needs to evolve with current changes in the medical system to adequately train surgical residents and also provide patients with safe, evidence-based care.
传统的外科学教学方法被称为“看一个,做一个,教一个”。然而,许多人认为这种方法已经不再适用,主要是因为对患者安全的担忧。本文旨在表明,如果将传统教学方法与各种成人学习原则相结合,其仍然是外科培训的基础。
作者回顾了有关外科住院医师培训计划形成历史、成人学习原则、指导和医学模拟的文献。作者提供了如何将这些学习技术纳入外科住院医师培训计划的示例。
直到最近,William Halsted 博士创建的外科住院医师培训计划几乎没有变化,住院医师的工作时间减少,以及基于能力的培训系统发生变化。这些变化减少了主治医生和住院医生之间的教学时间。学习原则,如经验、观察、思考和行动以及刻意练习,可以用来培训住院医师。指导也是教学外科技术的一个重要方面。作者回顾了不同类型的模拟器-标准化患者、虚拟现实应用程序和高保真人体模型模拟器-以及使用它们的优缺点。
外科住院医师培训计划中的传统教学方法“看一个,做一个,教一个”虽然简单,但仍然适用。它需要随着医疗系统的当前变化而发展,以充分培训外科住院医师,并为患者提供安全、基于证据的护理。