A review of innovations in surgical education: melding metacognition and technology

Abstract

The world of surgery is constantly evolving. With advances in scientific knowledge such as laparoscopy, robotic surgery and personalized medicine, the amount of medical knowledge and clinical skills that must be acquired continues to grow each day, increasing the demands on surgical residents and training programs. Furthermore, the implementation of duty hour restrictions limits the ability of trainees and residency programs to rely on developing expertise based on clinical experience alone. As a result, surgical education techniques must evolve in parallel to adequately prepare trainees to be competent, independent surgeons. One way for training programs to accomplish this daunting task is to explore adult learning theory. For example, surgical trainees must independently build a foundation of knowledge and operative skills to adequately prepare for clinical encounters with patients and to take full advantage of hands-on learning opportunities in the operating room (OR). The concept of metacognition, or having awareness of how one thinks, is essential for constructing a surgical training program that allows trainees to take ownership over their learning and development. More specifically, by investigating the principles of metacognition including cognitive pre-training, deliberate practice, and building mental models, educators can create new methods and tools to shape trainees into experts.