Challenges and opportunities to advance surgical education: a qualitative study

Abstract

Abstract Purpose Surgical educators and trainees are facing various challenges as surgical training continuously evolves. However, the needs in surgical education have not been well-defined in the literature to guide efforts at addressing existing challenges. Thus, the aim of this study was to identify the educational needs, challenges, and gaps in surgical education to identify opportunities to help address them. Methods Through phenomenology design, we used purposive sampling to conduct interviews and focus groups with surgical educators and trainees. To determine their educational needs, we implemented a gap analysis to explore the challenges and gaps in surgery based on our prior work. The challenges surgical educators and trainees were facing represented “what is” and the gaps represented “what should be,” which referred to the actions that should be taken to address these challenges. Through the examination of the differences between “what is” and “what should be,” the educational needs in surgery were defined. Thus, we recruited members of the executive committee and board of directors of the Association for Surgical Education (ASE) to participate in 30-min long semi-structured interviews to gain insight from leaders in surgery. To obtain diverse perspectives, we further recruited physicians, non-physicians, and trainees in surgery to attend 60-min focus groups. The interview and focus group data were analyzed using thematic analysis. Results The thematic analysis of the transcripts from 14 interviews and 7 focus groups among 43 participants generated three themes including the educational needs categories, cultural and systemic barriers, and resource limitations. The educational needs categories included learning needs, teaching needs, research needs, professional development needs, and leadership needs. Using these five categories of educational needs, we defined 26 cultural and systemic barriers and 26 resource limitations. A nested Venn diagram was created to synthesize the three themes into a conceptual framework of educational needs in surgery. Conclusions This study establishes a foundational understanding and overview of educational needs in surgery. The needs related to resource limitations will require department or school support to identify sustainable solutions, while the needs pertinent to cultural or systemic issues will require persistent advocacy from all surgical educators and trainees to advance surgical education.

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