Advancing Surgical Education: Theory, Evidence and Practice

Abstract

This chapter synthesises findings from observational studies of feedback in surgical education and the broader health workplace which illuminate the failure of feedback to do its job in improving trainee performance. Given this state of affairs, we argue for an alternative way of looking at feedback practices in surgical education. The recent frameworks proposed by Boud and Molloy (Assess Eval Higher Educ 38:698–712, 2013), Feedback Mark 1 and Mark 2, reconceptualise feedback as an activity driven by learners rather than an act of ‘telling’ imposed on learners. Through identifying their own needs, concerns and practice goals, learners are more likely to take on board the strategies raised for improvement. This dialogic form of feedback is more likely to develop self-regulatory capacities in the learner, but this requires displays of vulnerability and establishment of trust between parties. We argue that these dialogic communication strategies, centred around respect, trust and development of ‘the other’ in terms of reaching their goals, may transfer to surgeons’ skills in patient-centred care.