Teaching surgeons to operate--principles of psychomotor skills training.

Although the ultimate success of surgery depends on the use of adequate psychomotor skills, the evaluation of the abilities of a trainee and the teaching of these skills has not been systematized. The choice of a trainee in surgery should be based at least partially on his innate abilities, and his training should be begun at an appropriate level. The procedures he may do should be analyzed to determine the skills required for their performance. Then these skills should be taught specifically, initially in non-threatening situations such as laboratory settings, and their acquisition assessed so that he can be progressed to more advanced work at the appropriate time. Ultimately a decision must be made whether to train a candidate to a skill level or whether to train him for a set period and then counsel him regarding which procedures he has the skills to perform. There are well developed concepts in educational psychology that may be used in developing improved methods to assess and train prospective surgeons.