ASE 2025 Workshops

Session Description: The American Board of Surgery has implemented Entrustable Professional Activities (EPAs) as the core workplace-based assessment framework for General Surgery residents starting this academic year and for Vascular Surgery residents in the near future. The 18 EPAs broadly cover the domain of General Surgery and encourage repeated micro-assessments of performance across multiple phases of clinical care. Undoubtedly, there will be variable strengths and weaknesses between programs and residents on differing aspect of the 18 EPAs. The goal of this workshop would be to equip attendees with the knowledge and skills to create simulation based solutions to both teach and assess areas of EPAs that are difficult to consistently capture clinically or where performance is lower volume and highly variable.
Target Audience: PDs, APDs, Key clinical faculty, Skills lab directors, Education researchers.

Workshop outline:

Phase 1- Overview: The session would begin with three short presentations on 1- Key conceptual frameworks for teaching and
assessment with simulation (Kern, Kolb, Miller’s Pyramid) 2- Instructional and Assessment methods in simulation, & 3- Quick
overview of the EPAs and EPA program for those not as involved at the GME level. (Time: 35 mins including Q&A)
Phase 2- Group work: Attendees would be split into small working groups and given a copy of the EPAs and a blank
Curriculum or Assessment table to be filled in. Each group would pick 1-2 EPAs and develop a simulation based curriculum or
assessment template to fill a need that might be difficult to reliably acquire clinically. (Time: 30 mins)
Phase 3- Group discussion: Representatives from each group would share one or more of their templated ideas with the group
for open discussion and feedback with facilitation from workshop faculty. (Time: 25 mins)
Participants will leave with both the work product they and others developed, but also the frameworks to apply this simulation
development process to other EPA related challenges at their home institution.

Session Objective 1: Identify key conceptual frameworks for development of simulation-based instruction and assessment.
Session Objective 2: Apply simulation-based methods of instruction and assessment to Entrustable Professional Activities.
Session Objective 3: Develop a simulation based curriculum or assessment template to address at least one EPA.

Session Description: Background: Allyship is working for the inclusion of a marginalized group, not as a group member, but in solidarity with its struggle and point of view. In the surgical learning environment, members of marginalized groups struggle to enter the field of surgery and continue to suffer from additional challenges throughout their education and training that often lead to burnout and higher attrition rates. Surgical training often comes with a necessary but rigid hierarchy and power structure. Understanding privilege within this environment and how it can be leveraged to support marginalized communities in surgical training is critical to improving diversity, equity, and inclusion in surgery. Allyship exists along a continuum, spanning from apathy to awareness to action to advocacy. Allies who show awareness understand basic concepts about the structural challenges impacting marginalizing communities. Active allies are well informed about structural barriers, and their actions promote diversity when the opportunity arises. Advocates are committed to proactively championing inclusion by working for structural changes to increase diversity and promote a culture of belonging.

The proposed workshop is designed to give participants realistic strategies to move beyond awareness of issues and toward advocacy that is culture-changing in surgical learning environments, with the goal of improving  equity and inclusion in surgery. Session Format: Reference materials for the workshop will be distributed to workshop participants electronically and can be utilized to provide education at their institutions. DEI, Faculty Development, and CGR committee members will facilitate. The target audience will be both surgical trainees and faculty. The concepts of allyship and privilege will be introduced and discussed. Participants will learn about different levels on the allyship continuum and how they may be applied in different clinical and educational settings. They will then have the opportunity to practice applying awareness, action, and advocacy to different case scenarios in small group settings. A large group debrief of the case scenarios will identify strategies to optimize allyship in each scenario. Residents and faculty will complete the workshop with an improved understanding of how to move beyond being aware of issues faced by marginalized communities to being a champion who advocates for diversity and inclusion in the surgical learning environment.

Session Objective 1: Understand the meaning of allyship and the different levels of allyship, including awareness, action, and advocacy.
Session Objective 2: Define and recognize privilege, particularly in the surgical learning environment. Identify how privilege affects where on the allyship continuum an individual ally may have power to affect change in different settings.
Session Objective 3: Apply strategies for acting as an ally in different scenarios and for different individuals from diverse marginalized groups, including BIPOC, LGBTQIA+, and disabled communities.

Session Description: Explore the emerging technology of large language models (LLMs) and embark on a journey into the future of surgical education. While there is ongoing discussion regarding how to best implement LLMs into the medical field, there is no doubt this transformative technology has the potential to change medicine in extraordinary ways.

This workshop will unveil the groundbreaking potential of large language models, like ChatGPT, to revolutionize how we educate, research, and train the next generation of surgeons. Designed for all levels of surgical educators, this workshop will blend theory with hands-on experience, empowering participants with leading insights and tools.

Key Topics:

1. Introduction to LLMs: Starting with an overview of what language models are, and their potential scope in the realm of surgical education. We will introduce not only at ChatGPT, but other LLMs which are built for different purposes (such as Scite and MedPalm). We will also take a brief look at addressing the ethical challenges, biases, and safeguards in implementing these models in education. Finally, each workshop attendee will get a chance to use LLMs to improve abstract submissions for submitting to conferences in surgical education. This key topic will be interactive and encourage audience participation to enrich the overview of this important topic.
2. Interactive Application in Surgical Education:
   Case-Based Scenarios: Implementing LLMs in surgical scenario creation for students, residents, and fellows. Groups will study the importance of prompt structure and parameter generation when using LLMs. In this activity, participants will learn the significance of iterative improvement of GPT prompts and responses. Additionally, we will take a closer look at the quality of outputs from these models during this session and focus on common missteps when using LLMs.
3. Interactive Demonstrations: Dive into hands-on exercises using model platforms. Participants will be able to witness the model’s real-time responses, feedback mechanisms, and data interpretation capabilities.

This workshop promises not just information but inspiration, equipping participants to be vanguards of a new era in surgical education. Whether you’re an educator at the cusp of innovation or someone curious about the next big thing, this workshop will leave you enriched, enlightened, and empowered. Join us as we chart a course into the future, one where LLMs and surgical education converge for the benefit of surgeons and patients everywhere, unlocking unprecedented possibilities.

Session Objective 1: Appraise the foundational principles of large language models and differentiate their applications specific to surgical education and research.
Session Objective 2: Gain hands-on experience constructing meaningful prompts to utilize large language models in education, enhancing their use for students, residents, and fellows.
Session Objective 3: Evaluate the ethical implications of integrating these models into surgical education and formulate strategies to ensure responsible and effective application in their respective institutions.

Session Description: Peer review is important for maintaining the integrity of the scientific literature. Participation in peer review is helpful for growth and development as an academic surgeon and leads to editorial board positions and leadership. However, most surgeons do not receive training in peer review, how to get involved with peer review, or how to improve their peer review skillset. Furthermore, there remains a lack of diversity in editorial leadership at surgical journals which may, in part, be due to a lack of opportunity to perform peer review by underrepresented surgeons. The AWS Peer Review Academy and ASE Trainee Taskforce have joined forces to propose a session that covers a consolidated version of the AWS Peer Review Academy year-long curriculum including basics of peer review, understanding and reducing bias in peer review and how to get involved and ‘noticed’ as a reliable and high-quality peer reviewer and attain editorial leadership positions. Trainees that participate in the workshop will become eligible to serve as a Trainee Reviewer for Global Surgical Education-Journal of the Association for Surgical Education.

Session Objective 1:  Learners will develop a basic skill set for structuring a quality peer review.
Session Objective 2:  Learners will understand how to become involved with journals and apply this skill set effectively.
Session Objective 3:  Learners will gain knowledge to identify and mitigate bias in peer review.
Session Objective 4:  Learners will be introduced to the editorial board leadership pathway and how to advance from beginner to leader at peer reviewed journals.

Session Description: Asynchronous practice has become widespread in the setting of virtual and remote learning. Such practice allows trainees to hone their abilities in a low-stakes environment from a convenient location at any time. However, proper skill acquisition requires feedback for trainees to acquire appropriate habits and to speed learning. Providing technical feedback presents challenges in any setting; however, giving high-quality asynchronous technical feedback requires additional skills due to constraints and delays in communication. As such, this session will focus on the scenarios in which asynchronous practice may be appropriate to introduce into surgical training and the ways in which feedback can be optimized in such settings. We will begin with a discussion of feedback challenges by asking participants to brainstorm challenges that they have encountered with technical feedback. We will then provide an overview of asynchronous practice and a discussion of evidence-based techniques to provide high-quality feedback. The overview will draw from published studies of asynchronous practice in multiple surgical areas to outline the breadth of possible applications. This overview will also review faculty members’ and trainees’ reservations with regard to asynchronous feedback. It will further draw from quantitative and qualitative studies to identify the components of high-quality feedback, how those components apply to asynchronous feedback, and where peer and faculty feedback differ.

We will then review sample trainee videos as a large group with examples of asynchronous feedback. As a group, we will appraise the asynchronous feedback and discuss strategies for improving the feedback quality. We will review one sample video of a trainee performing an open surgical skill and another sample video of a trainee performing a laparoscopic surgical skill. In a large group, we will discuss the best practices as related to each video. Next, we will split into small groups and practice providing asynchronous technical feedback for additional videos. The session moderators will circulate among small groups as participants review two additional videos of trainees asynchronously performing open and laparoscopic surgical skills. We will reconvene to review the small group practice and ask participants for challenges and lessons learned. We will conclude the session by highlighting key takeaways, discussing future directions for asynchronous feedback (including with entrustable professional activity assessments and the use of artificial intelligence through computer vision and large language models), and answering participant questions. Session moderators will include a multi-institutional team with extensive experience designing, implementing, and evaluating asynchronous technical training programs for open, laparoscopic, and robotic surgery.

Session Objective 1: Identify barriers to providing high-quality technical feedback
Session Objective 2: Recognize technical skills for which asynchronous technical feedback can promote trainee practice and skill acquisition
Session Objective 3: Describe evidence-based techniques to provide high-quality technical feedback
Session Objective 4: Apply evidence-based techniques to sample trainee videos and produce high-quality asynchronous technical feedback

Session Description: Transitioning from residency or fellowship to junior faculty attending occurs abruptly and demands an immediate increase in responsibility for both patient safety and learner education, particularly in the operating room. Concerns about trainee autonomy and proper preparation for independent and safe practice have appeared across the surgical literature. While some literature has documented that junior faculty face struggles in their new role, a scarcity of research exists describing why this may be the case and how to overcome these struggles. In the operating room, junior faculty in the operating room must juggle many things, including time, efficiency, cost, patient safety, education, supervision, and, a multi-disciplinary health care team. Given the lack of literature describing what methods junior surgeons use to educate learners, as well as what difficulties they may face in doing so, a recent needs assessment was conducted by ASE GME Committee. Junior faculty attendings were asked to report, among other things, whether they have struggled in their transition from trainee to educator, and strategies used for teaching across the operative process (pre-, intra- , post-). One important theme that emerged was the presence of ‘cognitive overload’ felt by junior faculty in the operating room. Faculty described having “simultaneous stressors” in the operating room, such as multiple learners across the education spectrum with varying levels of knowledge and skill, in whom they had to assess level of proficiency, optimal learning style, and provide actual instruction or supervision, all while maintaining patient safety and efficiency. Cognitive load (or overload) is not well-described in the surgical literature, with better descriptions coming from its roots in cognitive psychology (“Cognitive Load Theory”). Cognitive Load Theory has become a prominent model in educational psychology and has gained traction in the medical education community in recent years. For example, one study found that additional ‘mental skills’ training for junior surgeons prior to a demanding surgical simulation elevated their ‘spare attentional capacity,’ a finding typically seen in more senior attendings. Findings like this suggest that more senior attendings have developed strategies over time to manage the demanding cognitive load in the operating room, but it is unclear what those strategies are and how junior faculty can develop them. Our objective is to provide information on the existence of ‘cognitive (over)load,’ including clinical scenarios in which this may occur and to discuss and describe strategies used by junior faculty members in the operating room to support or mitigate ‘cognitive overload.’ The target audience for this workshop would be senior residents, fellows, and junior faculty. Senior faculty are welcome to attend and add to the discussion about overcoming the struggles with cognitive load, given their valuable perspective.

Session Objective 1: Provide background and information on the existence of ‘cognitive load’ or ‘overload,’ including clinical scenarios in which this may occur, for junior surgeons in the operating room
Session Objective 2: Discuss and describe the ways in which junior attendings / surgeons feel their concentration is overloaded in the operating room by needing to pay attention to multiple stressors (e.g., patient safety, details of the case, education of the learner)
Session Objective 3: Delineate what types of short-term (i.e., ‘in the moment’) and long-term (i.e., preventing prospectively) interventions or specific education strategies may best support both trainees transitioning to practice (i.e., residents, fellows) and junior attending surgeons during this transition period

Session Description: Are your medical students and residency applicants asking about “global surgery” opportunities at your institution? Do you offer any rotations away from your institution? Do your surgery faculty or staff participate in volunteer surgery activities, at home or abroad? Do the costs of international experiences hinder consideration? Regardless of your answers to any of these questions—yes, no, not sure—this workshop will provide a forum for those experienced within international elective rotations or domestic volunteer opportunities to share with those who may be thinking about implementing these activities. The primary focus will be on looking at alternatives to international programs, although the pros and cons of international rotations will be shared. This workshop will be led by surgeons who have worked in their local community as well as internationally. A 10-15 minute overview contrasting local versus international “global” opportunities will kick off the workshop. The leaders will than open the floor for an interactive discussion.

Suggested topics include:

• supervision
• finances
• leveling the playing field for folks who can’t travel
• community clinics for the un- and under-insured
• underserved populations such as the Indian Health Service, patients experiencing homelessness
• carbon footprint of air travel
• medical ethics
• refugee resettlement programs
• advocacy

Attendees with experience in any of these areas will be encouraged to share and those seeking to create opportunities for students or residents can ask questions of the workshop leaders and fellow attendees. Attendees should be able to take back to their home institution a broadened understanding of “global surgery” as “glocal surgery” with ideas related to the advantages (e.g., lower costs, reduced carbon footprint, less impact on family responsibilities, etc.) of activities and rotations developed in their own community or nearby.

Session Objective 1: Attendees will be able to define global surgery in its broadest sense—in the local community as well as internationally.
Session Objective 2: Attendees will learn about identifying and assessing learning/volunteering opportunities as well as the advantages of developing “global surgery” programs in their own communities
Session Objective 3: Attendees will meet surgeons with experience in local and international surgical electives and thus have contacts with whom to continue the dialogue if they need guidance in developing rotations in partnership with international as well as local colleagues and institutions.

Session Description: With so many competing responsibilities, many of our teaching faculty are losing the drive to support the education of our students and residents.  Balancing clinical productivity expectations, administrative tasks, and maintaining a home life often drops education down the priority list of our overworked faculty.  The purpose of this workshop is to provide a variety of implementable interventions that address many of the barriers to being engaged in teaching activities including lack of time, funding, and motivation.  After our introduction, participants will have the opportunity to rotate to 4 different small groups on different topics over the course of 60 minutes.  Our expert facilitators will lead small group break outs on specific topics to share strategies and resources that have been successful in their practices as well as the opportunity to let participants help troubleshoot related challenges they have at their institutions.  Break out topics will include improving motivation by taking on new challenges, how to host successful new idea workshops with faulty, exploring internal motivation, and finding funding for education support and time.  A google drive for the workshop will also be shared with participants that includes presentation materials, handouts, and references provided by each facilitator and speaker for use at participant’s home institutions.  In addition a short presentation will be given to the whole group on how to spark culture change at their home institution.  Updates on the ASE sponsored Health Systems Impact on Education Survey will also be provided to participants.

Session Objective 1: Identify barriers to keeping teaching faculty engaged in education activities
Session Objective 2: Evaluate ways to build on internal motivators to reinvigorate faculty
Session Objective 3: Develop implementable strategies to address the specific barriers identified at each participant’s institution
Session Objective 4: Create a plan to support culture change

Session Description: The health effects of climate change are set to become the greatest threat to global health of the 21st century. Healthcare contributes 8%-10% of all carbon emissions in the United States, a significant proportion of which is generated from surgical services. The operating room uses 3-6 times more energy per square foot than the rest of the hospital and generates hundreds of tons of waste yearly. The global warming potential of anesthetic gases ranges from 350-fold (sevoflurane) to 3700-fold (desflurane) higher than an equivalent weight of CO2. With such a heavy carbon footprint, surgeons are called to action in mitigating the impact of surgical services on the climate.

In the United States and abroad, hospital systems are finding ways to decrease their negative impact on climate change. At a national level, Practice Greenhealth, the country’s largest organization for healthcare sustainability, dedicates a substantial portion of its activities to sustainability in the operating room. 837 hospitals have signed the Department of Health and Human Service’s pledge to reduce carbon emissions by 50% by 2030 and achieve net-zero emission by 2050. Locally, many hospitals are working to implement decarbonization interventions, but many of these are designed in isolation and without knowledge of prior successful interventions in similar circumstances. The workshop will provide participants with an understanding of the fundamentals of climate change science and the main sources of carbon emissions in the operating room. Additionally, participants will have the opportunity to share their ideas and experiences about OR environmental sustainability with faculty and other participants. This workshop will facilitate participants’ ability to engage in decarbonization efforts in their own surgical practice at their home institution. The target audience will be surgical trainees and faculty. Reference materials for the workshop will be shared with participants via email in advance (if possible) and with a QR code at the session. The workshop will first review the fundamentals of climate change science in a large group format. Participants will then break into groups of 4-6 people to learn about the sources of carbon emissions in surgery and the initiatives to mitigate carbon emissions. A large group debrief will examine differences in points of view from participants in diverse practice settings and stages in training. The session will conclude with a review of education solutions to climate change mitigation and a space to answer participant questions. Participants will leave the workshop with a deeper understanding of our impact on climate change as surgeons and ways to mitigate carbon emissions from our role as leaders in the surgical team.

Session Objective 1: Understand the fundamentals of climate change science, including its effects on human health and health equity
Session Objective 2: Appreciate the impact of climate-related negative health consequences among vulnerable populations in the United States and abroad
Session Objective 3: Recognize the main sources of carbon emissions in the operating room
Session Objective 4: Apply evidence from the literature to each participant’s environment in selecting appropriate initiatives to decarbonize surgical services
Session Objective 5: Identify opportunities to utilize surgical education concepts to potentiate collaboration in decarbonization efforts