The Association for Surgical Education

Impacting Surgical Education Globally

 

 

Thinking Out of the Box - Videos Only

 

NAVIGATING DIFFICULT CONVERSATIONS: FEASIBILITY AND ACCEPTABILITY OF A COMMUNICATION CURRICULUM FOR UROLOGY RESIDENTS
Vivian Wong, MD1, Raeesa Islam, MD2, Tasha Posid, MA, PhD3, Eric Singer, MD, MA, MS, FACS, FASCO3, Biren Saraiya, MD2; 1The Ohio State University, 2Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, 3The Ohio State University Comprehensive Cancer Center, Department of Urology

What problem in education is addressed by this work? The American Board of Urology mandates that physicians pass an oral examination, which includes demonstrating proficiency in navigating difficult conversations, as a requirement for board certification. However, a comprehensive, well-researched communication skills curriculum has yet to be established in urologic training. Describe the intervention: This study implements a structured communication skills curriculum at two ACGME-accredited urology residency programs. The curriculum provides foundational training in communication techniques, the use of structured communication tools such as SPIKES and NURSE for delivering difficult news, promotes the deliberate practice of these skills, and incorporates real-time feedback on resident interactions. The curriculum will be delivered through monthly virtual or in-person sessions incorporating didactic instruction, interactive case-based scenarios, and group exercises. Describe the improvement/outcome of the intervention. Effective communication is a critical yet underemphasized component of urologic training, particularly in navigating difficult conversations. By implementing a structured communication skills curriculum, we aim to bridge this gap and enhance residents' ability to engage with patients more effectively. Ultimately, improving communication skills among urology trainees may lead to better patient interactions, increased confidence among physicians, and enhanced overall patient care. Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome. This curriculum can be scaled to other urology and surgical residency programs through shared virtual sessions, standardized materials, and integration into existing educational frameworks. Potential barriers, such as limited faculty time and competing curricular priorities, can be mitigated by designating faculty champions, leveraging virtual delivery, and fostering inter-institutional collaboration to sustain engagement and feasibility.

 

 

TIMEOUT: STORIES FROM THE OPERATING ROOM
Kathryn Radulovacki, BA, Trevor Sytsma, MD, Kennedy Carpenter, MD, Zoe Hinton, MD, Conor O'Neill, MD; Duke University School of Medicine

What problem in education is addressed by this work? Medical students often begin their surgical clerkships with significant anxiety due to limited familiarity with the operating room (OR) and uncertainty regarding their role within the surgical team. These barriers can lead to disengagement and negatively affect learning and interest in surgical careers. A growing body of evidence suggests that storytelling can be an effective pedagogic tool in medical education and enhance engagement in the clinical environment. Describe the intervention: We developed a 21-minute video featuring surgeons, residents, and OR staff sharing positive stories about medical student contributions during surgical care. The video was approved for distribution before the start of every student’s surgery block by the clerkship educational leadership at our institution. It aims to equip learners with practical examples of success, increase their confidence in the OR, and empower them to engage meaningfully in patient care, ultimately enhancing their clerkship experience. Describe the improvement/outcome of the intervention. Informal feedback from medical students suggests that viewing the video prior to beginning the clerkship has helped them to feel more prepared to engage in the OR environment and participate in patient care. Faculty have also expressed enthusiasm for its ability to set a positive tone for the clerkship and promote a more inclusive learning culture. A formal qualitative and quantitative analysis using one year of end-of-clerkship student evaluation data is planned. Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome. Other institutions may benefit from implementing similar storytelling-based videos tailored to their surgical teams. Barriers may include limited faculty time and technical resources, which may be addressed by involving student collaborators, using simple recording methods, and integrating the project into existing clerkship orientation structures. Alternatively, they could use the video our group created, which we will gladly distribute.

 

 

PATHOLOGY FOR SURGEONS AND RADIOLOGISTS: A SIMULATION-BASED INTERDISCIPLINARY CURRICULUM BRIDGING COMMUNICATION AND KNOWLEDGE GAPS IN BREAST CANCER CARE
Sin Yee (Amelie) Lim, BS1, Tara Krishnan, MD2, Kareem Hosny, MD, MBBCh, MPH2, Mark Kilgore, MD2, Diana Lam, MD3, Farin Amersi, MD4, Areti Tillou, MD5, Estell J. Williams, MD6, Kenechukwu Ojukwu, MD, MPP, MS7, Emily Palmquist, MD6; 1David Geffen School of Medicine at UCLA, 2Department of Laboratory Medicine and Pathology, University of Washington, Seattle, 3Department of Radiology, University of Washington School of Medicine, Seattle, 4Dep

What problem in education is addressed by this work? Surgical trainees receive limited formal education about pathology workflows despite making critical intraoperative decisions about specimen handling, margin assessment, and frozen section requests. Miscommunications between surgeons, radiologists, and pathologists contribute to surgical specimen errors occurring in up to 1% of collected specimens [1], leading to diagnostic delays, repeat procedures, and adverse patient outcomes. Current surgical training lacks structured curricula that prepare trainees for active collaboration with pathology, leaving trainees to learn critical workflows through trial and error rather than deliberate instruction, which challenges effective collaboration across specialties and can compromise the interdependent workflows essential for optimal patient outcomes. Reference: 1. Heather J Carmack, Braidyn S Lazenby, Kylie J Wilson, Jamie N Bakkum-Gamez, Leslie Carranza, Lost, mislabeled, and mishandled surgical and clinical pathology specimens: A systematic review of published literature, American Journal of Clinical Pathology, Volume 162, Issue 4, October 2024, Pages 349–355, https://doi.org/10.1093/ajcp/aqae055 Describe the intervention: Grounded in Experiential Learning, we developed a 2-hour simulation-based curriculum bringing surgery, pathology, and radiology trainees together to demystify the obscurity of surgical pathology through the lens of breast cancer care. The intervention comprised four interactive 30-minute sessions addressing real-world clinical challenges, including specimen chain-of-custody tracking, diagnostic discordance management, hands-on silicone mastectomy specimen grossing, and guided discussions on intraoperative consultations. Sessions were co-designed and co-facilitated by breast surgical oncologists, pathologists, and radiologists, with senior residents serving as peer instructors at an academic medical center. Describe the improvement/outcome of the intervention. At our most recent session in January 2025 with 47 participants (23 surgery, 21 pathology, 3 radiology trainees), we observed statistically significant knowledge score improvement from 14.38 to 16.28 out of 20 points (p=0.002), with surgical trainees achieving the greatest gains from intervention and 68% of participants demonstrating measurable learning gains. Qualitative feedback revealed shifting attitudes towards collaboration, for example one trainee share they would “not hesitate to reach out to pathology colleagues with questions.” Participants particularly valued the hands-on nature and real-world relevance of activities, emphasizing the curriculum taught practical information "that would be hard to learn without someone explicitly teaching it"—knowledge critical for safe surgical practice but traditionally absent from surgical training. Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome. The curriculum is designed for scalability across institutions with surgery and pathology residency programs, using accessible technology (QR codes, videos) and adaptable simulation materials (in-house silicone breast models). Successful implementation at three diverse academic centers demonstrates reproducibility, with scheduling barriers across disciplines overcome by embedding sessions into existing didactics and engaging senior trainees as peer instructors to reduce faculty burden. This model fulfills ACGME systems-based practice goals and addresses a critical gap in surgical education by fostering early collaboration with pathology and radiology to prevent errors that compromise patient safety.

 

 

PRINTING POSSIBILITIES: USING 3D-PRINTED SURGICAL MODELS TO SPARK EARLY INTEREST IN SURGERY AMONG UNDERREPRESENTED HIGH SCHOOL STUDENTS
Jasnoor Singh, BS1, Sharmi Amin, BA1, Chidera Osuji, BS1, Lauren Szczygiel, PhD2, Clarice Gaines MS2, Rachel Hooper, MD3; 1University of Michigan Medical School, 2Center for Healthcare Outcomes and Policy (CHOP), Michigan Medicine, 3Michigan Medicine Department of Plastic Surgery

What problem in education is addressed by this work? The racial and ethnic diversity of the surgical workforce continues to lag behind that of the patient populations it serves [Fan, Patel]. Few initiatives to improve this currently engage underrepresented in medicine (URiM) students at the high school level, but early hands-on exposure has been shown to foster confidence, belonging, and interest in surgical careers [Mohan]. Approachable simulation-based learning using realistic three-dimensional (3D) models for surgical anatomy is a stress-free, engaging tool for high school students who may otherwise be deterred by traditional demonstrations or graphic images and videos [Mohan, Giblett]. Describe the intervention: In 2024, we created the Surgical Training and Readiness for Tomorrow (START) program at the University of Michigan to engage URiM high school students in the Detroit-area and to provide early exposure to medicine and surgery. As part of this initiative, we 3D-print low-cost hand bone models to introduce high school students to hand anatomy and surgical scenarios in a relaxed setting. Each model (cost: $1.67 USD, print time: 4 hours, 52 minutes in Polylactic Acid (PLA)) is easily reproducible and used by faculty and student mentors to discuss anatomy and hand surgery clinical scenarios in real time. Describe the improvement/outcome of the intervention. Early experiences indicate that students find the 3D-printed models engaging and prefer hands-on exploration to passive observation or lectures during sessions. Their realistic size, low-cost, and customizability allow multiple learners to visualize anatomy, bone relationships, fractures, and surgical repairs in a stress-free environment. By incorporating these models in surgical case discussions, these experiences can foster curiosity and early interest in surgical careers among students who might not otherwise envision themselves in the field. Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome. Commonly cited barriers to using 3D-printing in medical education include cost, limited equipment access, or lack of technical expertise. However, these can be mitigated through open-source model files and free model editing software such as Autodesk MeshMixer; collaborations with local engineering departments, university makerspaces, or local libraries also offer affordable printing access. By integrating this approachable educational tool into existing outreach or mentorship programs, institutions can engage underrepresented students earlier in the educational pipeline, helping to reduce exposure gaps and promote a more diverse surgical workforce.

 

 

THINKING BEYOND THE CHECKLIST: A MULTIDISCIPLINARY CREW RESOURCE MANAGEMENT CURRICULUM TO STRENGTHEN OR TEAM CULTURE AND PATIENT SAFETY
Mika MATSUUCHI Lindsley, MD, MPH, Dena Shehata, MD, Erin Brady, BSN, Dmitry Nepomnayshy, MD, MSc; Lahey Hospital & Medical Center

What problem in education is addressed by this work? Operating room (OR) team training at our institution historically focused on attending surgeons and anesthesiologists, leaving nurses, scrub technicians, CRNAs, and trainees with limited exposure to shared teamwork principles. This created persistent gaps in communication, teamwork, and leadership during high-stakes perioperative care. This work addresses the need for a truly multidisciplinary, practice-based education to improve operating room safety culture. Describe the intervention: A multidisciplinary Crew Resource Management (CRM) curriculum was designed to bring attending surgeons, anesthesiologists, nurses, scrub technicians, CRNAs, and residents into shared learning. The program combines concise didactics (focused on effective leadership, creating a team, and structured communication) with targeted OR simulations, and guided debriefs. Simulations are tailored to address problems relevant to the operating room team and focused on communication failures, such as wrong-sided surgeries and retained surgical instruments. Describe the improvement/outcome of the intervention. The AHRQ SOPS Hospital Survey 2.0 is used to evaluate changes in safety culture domains most relevant to the operating room, including teamwork, leadership support for patient safety, communication openness, and information exchange, before and after implementation. Greater improvement is expected among nursing staff and scrub technicians, who were underrepresented in previous physician-focused training initiatives. Safety culture survey data are paired with participation metrics to assess the impact of enhanced multidisciplinary engagement on overall safety culture. Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome. The didactic components are broadly generalizable, and simulation scenarios can be readily adapted to reflect local cases, protocols, and institutional policies, whether conducted in established simulation centers or in situ. Potential barriers include limited facilitator availability and challenges in scheduling multidisciplinary staff. These can be mitigated by securing perioperative leadership support, hosting Train the Trainer sessions to increase instructor pool, aligning sessions with staff schedules, and integrating participation into onboarding processes and continuing medical education programs.