Shortcomings of traditional teaching methods

Surgical skills are essential for nearly every medical specialty, with variations in their specificity and complexity. This is an important point to emphasize to students, as it can strengthen their motivation to learn surgical techniques. For instance, physicians in therapeutic fields often perform numerous minor surgical interventions, such as punctures and biopsies, which require fundamental surgical skills, including the application of aseptic principles and the manipulation of procedures.

On the other hand, physicians of surgical specialties must acquire more advanced skills related to diagnostics and surgical manipulations, as well as proficiency in using various modern instruments and robotic systems. Nurses also encounter certain procedures that necessitate surgical skills, such as wound care, management of trophic ulcers, pressure sore treatment, bladder catheterization etc. Operating room nurses must also be familiar with instruments and equipment, and be able to prepare them for surgery.

The training of surgical skills should be structured in a tiered manner, beginning with basic knowledge and skills in early study years, supplemented by specialized knowledge and skills in advanced courses and residency, and continuing throughout a physician’s career as they develop expertise and share their experiences. However, traditional methods of teaching surgical skills have significant shortcomings (Table 3.), which can leave students feeling inadequately prepared and failing to meet the required standards, ultimately leading to a decrease in interest in pursuing a surgical career [1].

Table 3. Shortcomings of traditional teaching methods

Passive Learning	Traditional methods often rely on lectures and rote memorization, which can lead to passive learning. Students may struggle to engage with the material actively, making it harder to retain information
Limited Practical Application	There is often a gap between theoretical knowledge and practical application. Students may learn concepts without sufficient opportunities to practice them in real-world scenarios.
One-Size-Fits-All Approach	Traditional teaching often does not account for individual learning styles and paces. This can leave some students behind while others may not be challenged enough
Inflexibility	Rigid curricula can limit adaptability to new information or techniques. In rapidly evolving fields like medicine, this can hinder students from learning the latest practices
Insufficient Feedback	Traditional settings may not provide timely or constructive feedback, which is crucial for improvement. Without regular assessments and guidance, students may not recognize their weaknesses.
Stressful Learning Environment	High-pressure environments, common in traditional settings, can lead to anxiety and hinder learning. A supportive atmosphere is essential for effective skill development
Neglect of Soft Skills	Traditional methods often focus on hard skills and technical knowledge, overlooking the importance of soft skills like communication, teamwork, and emotional intelligence, which are vital in surgical practice.
Insufficient number of cases	Without a diverse range of cases, trainees may miss out on critical learning experiences that are essential for mastering surgical techniques. Exposure to a variety of clinical cases is crucial for developing a well-rounded skill set. Students may miss out on important experiences that could enhance their adaptability to handle unexpected situations in real practice.
Ethical Constraints	Ethical guidelines dictate that patient welfare must always come first. This means that any training involving patients must prioritize their safety and comfort. Trainees must not perform procedures that could harm patients or compromise their care, which can limit the types of skills they can practice.
Data Protection	The protection of patient data is paramount. Healthcare professionals must adhere to strict regulations regarding patient confidentiality and data security. This can restrict the use of real patient cases for training purposes, as sensitive information must be safeguarded, limiting the availability of diverse clinical scenarios for practice.
Patient Refusal	Patients have the right to refuse participation in training programs. This autonomy can lead to a reduced number of cases available for trainees, as not all patients will consent to have their procedures used for educational purposes. This can create gaps in training opportunities and limit the exposure of trainees to various surgical techniques.

It should not be forgotten that the word chirurgia (surgery) is derived from the Greek words χείρ the hand, and ἔργον a work, and is explained by Celsus (De Med. lib. VII. Praefat.) to mean that part of medicine quae manu curat, “which cures diseases by means of the hand;” in Diogenes Laërtius [2], therefore until now different from other clinical specialties, for surgical trainees is not enough to study books and watch video material, but it is necessary to improve specific hand manipulations and sensations.

Sources:
[1] Glossop SC, Bhachoo H, Murray TM, Cherif RA, Helo JY, Morgan E, Poacher AT. Undergraduate teaching of surgical skills in the UK: systematic review. BJS Open. 2023 Sep 5;7(5):zrad083. doi: 10.1093/bjsopen/zrad083. PMID: 37819804; PMCID: PMC10566575.
[2] https://penelope.uchicago.edu/Thayer/E/Roman/Texts/secondary/SMIGRA*/Chirurgia.html