PS3-10: LEARNING ON THE SURGICAL POST-TAKE WARD ROUND: A MISSED INFORMAL EDUCATIONAL ACTIVITY
Adarsh P Shah, MBBS, BSc, MRCS, MEd; Imperial College London

The surgical post-take ward round (PTWR) is an important routine daily clinical activity within each hospital’s surgical department. The PTWR is not a formal educational activity and has not been the subject of much educational research. Literature studies and survey results have consistently demonstrated the adverse effects of changes in work patterns and systemic pressures within the healthcare systems on surgical education and training. This study aims to illuminate junior doctors’ conceptions of learning on the surgical PTWR – what do learners learn? How they learn? How is it taught?

For this qualitative study, twelve surgical doctors of all grades at a busy UK district general hospital were purposively sampled. Field notes on observed PTWRs and semi-structured interviews provided data, which was subject to open iterative coding and thematic analysis. A constructivist stance and grounded theory approach were adopted for the study.

This study demonstrates that the PTWR is a valuable, but frequently missed, educational opportunity where learners gained surgical knowledge and clinical skills. Learners employed active and passive learning approaches, with the most junior learners employing mainly passive learning techniques and vice versa. Individual and systemic barriers to learning and teaching were identified. Improving workplace affordances, changes in learner and teacher attitudes and improved communication between them were the main themes for improving the educational value of surgical PTWRs.

This study highlights a ‘generation gap’ whereby teachers’ own experiences of experiential learning in a traditional apprenticeship model contrasts with current learners’ needs, which emphasise socio-cultural learning theories. Stakeholders involved in surgical training ought to recognise the educational significance of the PTWR.