7/28/2019 Surgical Teaching and Learning by Medical Students in the Operating Theatre: A Cross-sectional Study

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Surgical Teaching and Learning by Medical Students in

the Operating Theatre: A Cross-sectional Study1 Nottingham University Hospitals NHS Trust, Nottingham, UK 2 Royal Marsden Hospital NHS Trust, London, UK

P. Ravindra1, M. Shah1 and J.E.F. Fitzgerald2

Methods

A 41-item, self-administered, non-mandatory questionnaire survey was

distributed to newly qualified graduates at a UK medical school. Resultsanalysed using GraphPad Prism 5.0.

Presented at the Association of Surgeons of Great Britain and Ireland meeting Liverpool Contact Mr Edward Fitzgerald: edwardfitzgerald@doctors.org.uk

Conclusions

Attendance at operating theatre sessions by all medical students is low,

particularly amongst those not already interested in a surgical career.

These results highlight the need to ensure time is spent by medical students

in the operating theatre, and that this experience is positive for them.

The potential educational benefit should to be maximised through adequate

preparation of students for the operating theatre environment in advance (e.g.

teaching to scrub) and structured learning involving all team members.

References Ravindra P, Fitzgerald JE, Bhangu A, Maxwell-Armstrong CA.Quantifying factors influencing operating theater teaching,

participation, and learning opportunities for medical students in surgery. J Surg Educ. 2013 Jul-Aug;70(4):495-501.

Nagraj, S, Wall D, Jones E (2006). Can STEEM be used to measure the educational environment within the operating theatre

for undergraduate medical students? Medical Teacher, 28:7, 642-647.

Lyon, P (2004). A model of teaching and learning in the operating theatre. Medical Education, 38, pp 1278-1287.

Lempp, H, Seale C (2004). The hidden curriculum in undergraduate medical education: qualitative study of medical students

perception of teaching. British Medical Journal, 329, pp 770-773.

Table 1: Experiences and comments received by medical students in theatre

I was told to stand against the wall of the operating theatre and to stay out of the

way it was very difficult to get involved from this position or gain anything from the

experience.

I just kept being shown up and embarrassed unnecessarily to the point where I

simply left the theatre.

Sleazy and misogynistic remarks by the consultant.

The theatre nurses had a poor attitude and would pass negative comments on my

presence

I was continually mocked for not knowing the answer.

Results

Questionnaires were returned by 209 of 312 graduates (67%).

117 female (57%), 87 male (43%)

153 (75%) standard undergraduate, 51 (25%) graduate-entry.

119 (57%) respondents attended 50% of opportunities available to attend

operating theatre.

27 (13%) respondents stated that they wished to pursue a surgical career

after graduation; this group was more likely to have attended 50% of operating

theatre opportunities (p=0.001).

However, those who wanted to pursue a surgical career were not more likely

to participate (p=0.272).

Those who did not wish to pursue a surgical career were more likely to havebeen put off by their experiences in theatre (p=0.0001).

Those actively taught during their time in theatre found the experience

beneficial (p=0.0001)

They also reported that opportunities to participate increased as attendance at

theatre increased (p = 0.003).

Although female respondents did not feel less welcome in the operating

theatre, in comparison to their male colleagues they were more likely to receive

negative comments (p=0.005).

Examples of experiences and comments received by students are shown in

Table 1.

Introduction

Operating theatres offer a unique learning resource to medical students.

Teaching can include anatomy, pathology, physiology, anaesthesia and surgical

technique. However, there are particular difficulties in harnessing its benefits.

These include both cognitive and non-cognitive factors, including the alien

nature of the environment to newcomers, inexperience with the operative

procedures and techniques, and unfamiliarity with the workflow and team roles.

This study aimed to assess the operating theatre-based teaching and learning

experiences of new medical graduates during their medical school course.