teach surgical skills to medical students
Trainers are essentially teachers. Our learners are not just the animals we train; our learners are also our clients, students, employees, and colleagues. Most of us spend a great deal of time perfecting our animal-training knowledge and skills, but few of us focus on skills that relate to the human learners—often creating our biggest challenges. I recently spoke at a surgeon’s symposium in New York City that highlighted the universality of these challenges.
The invitation to participate in the symposium came from Dr. Martin Levy, a practicing orthopedic surgeon at Montefiore Medical Center. Dr. Levy had teamed up with Karen Pryor and Theresa McKeon to explore using TAGteach principles to teach basic surgical skills to medical students, such as setting up surgical instruments, using various tools, and tying suture knots. You can read a brief summary of the project. For a more in-depth look, check out this article in Scientific American. The symposium brought nine speakers together to show doctors in the New York City area the history of training, the science behind it, and the results of the project to date.
Here are some of the requirements we identified during that post-symposium meeting:
- Know the science and tools well. Stay current with new scientific breakthroughs, and master the new skills.
- There are different types of learners. Adapt your teaching style accordingly. For example, new medical students are part of the generation referred to as millennials. Some research indicates that this generation has a shorter attention span, thinks independently, and is accustomed to learning through electronic media.
- Break skills into the smallest possible components. The learner can then master each of the smaller tasks that make up the larger, finished procedure. A surgeon must learn to use each tool and become proficient with handling and using those tools. Only after learning each individual skill can the whole sequence be put together successfully.
- Achieve fluency at each skill. Fluency is about achieving mastery or proficiency at a task, and that includes accuracy, speed, quality, and pace, among other things. It is important to “over practice” each skill so that it becomes second nature. Fluency is so important in the teaching process because it allows the learner to go from success to success, with few or no mistakes. Fluency is fun!
- Peer coaching. In most disciplines, eventually learners need to pass on what they have learned to others. Just because a medical student has learned a skill proficiently doesn’t mean he or she can teach others. The learning process needs to include the student learning to coach and help fellow students, and coaching ability consists of a different skill set. The surgical program included peer-coaching in the learning process from the very start.
- Collect and interpret your data. You need quantifiable evidence that the new tools are improving or enhancing the acquisition of skills or accomplishing your desired goal. This is where it is useful to enlist the aid and skill of behavior analysts.
- Examples of success. While data are essential, it is critical to have video or living examples that demonstrate clearly how the new tools have improved the task in some way. The scientific data alone is often not enough to convince people to adopt new tools.
- Assessment and feedback. Even the most successful programs can find areas for improvement. Evaluate the entire teaching process regularly so it can be adjusted and enhanced.
What became so clear to me during our discussions was that the steps and strategies for introducing professionals to new tools and ideas are similar across disciplines. I’ve worked with and seen successful transitions at Guide Dogs for the Blind, various law enforcement agencies, and organizations that have used TAGteach (such as Dr. Levy’s surgical teaching program), and I’ve seen again and again that being persuasive goes beyond simply understanding the science of learning.
The many steps and skills needed to introduce professionals to new skills or ideas can be frustrating. But we should take heart and find hope in the successes we see all around us. This recent breakthrough in the surgical community is just one more great example of the successful use of positive reinforcement and the application of good teaching skills.