Session Design Submission Review

Simulation-based training has grown exponentially, resulting in the need for well-trained
simulation educators. Surgical faculty are increasingly called upon to lead, develop,
and/or implement simulation curricula with little additional training in simulation
education theory or educational methodologies. 

Challenges arise around the availability of simulation equipment and centers, the
effectiveness of simulation teaching methodology, and objective demonstrations of
improvement in trainee skills and competencies. Lack of administrative support and/or
research support adds additional obstacles to the successful implementation of
simulation curricula.

The Association for Surgical Education Curriculum in Education Innovation and
Teaching (ASCENT) program was developed by the ASE Simulation Committee,
designed to share the expertise of leaders in surgical education on topics relevant to
simulation to improve knowledge and provide tools to be successful surgical simulation
educators.

This session will provide new and engaging discussions with surgical education
simulation leaders on delivering and evaluating simulation curricula as participants
navigate their own local environment with variable resources, highlighting the newly
established ASCENT program.

Simulation training is a vital part of modern surgical education and its importance in surgical training has been explored in various literature. However, most of these studies are being published from North America. Different countries and regions have their own approaches to incorporate simulation training in surgical education. This session will bring together surgical educators from around the world to give a global perspective on the state of simulation training. It will provide a view of the global landscape, from low-cost DIY setups to advanced training centers with cutting edge technologies, giving a broad overview of how different countries approach surgical simulation. The session will have case studies of countries with basic setups vs. those with cutting-edge technology, and will highlight the diversity in funding, access to resources, and training infrastructure. Each panelist will give an overview of simulation use in their region, success stories and challenges, resource availability, curriculum integration, role of government and private institutions in supporting simulation training. We will summarize the common challenges, give our view on how we can break these geographical and economic barriers and get simulation to trainees around the world.

We will engage the audience with panelists through a live Q&A, addressing specific questions on implementation, challenges, and future directions.

Multi-institutional research collaborations bring together diverse institutions with varying geographic locations, institutional cultures, clinical practices (academic, community hospital based, or hybrid), and research backgrounds. These collaborations play a pivotal role in fostering more inclusive research. Such collaborative research helps overcome limitations of individual institutions, leading to more inclusive, comprehensive, generalizable, and impactful findings. 

Early career researchers and educators often face challenges when it comes to initiating and navigating multi-institutional research and collaborations. Despite the growing recognition of the benefits of such collaborations, these researchers frequently lack the necessary skills and experience to engage effectively in multi-institutional projects. This gap highlights the need for targeted training and support for early career researchers, which is the primary focus of this panel. The ASE’s report on priorities identified several barriers in multi-institutional surgical education research, and this panel aims to address those issues as outlined below.

Outline:

At the beginning of the panel, we will briefly highlight how multi-institutional research inherently promotes diversity by incorporating a wider array of study populations and involving contributors from various geographic locations, institutional cultures, backgrounds, and professional stages. To empower early career researchers to engage in multi-institutional research, the panel will focus on five barriers to conducting multi-institutional research: finding collaborators, funding and resources; institutional review board (IRB) coordination; rigor, institutional cultures, and practice variability; time constraints and communication; and authorship and recognition. We will discuss how ASE can assist in overcoming these challenges and explore how inclusive mentorship can further empower early career researchers and transform the way multi-institutional research is conducted. These barriers are derived from a prior ASE report on priorities in multi-institutional surgical education research. 

The panel will convene experts in these areas, including three faculty members and two CoSEF resident members. We will begin with brief introductions of the panelists, followed by a five-minute overview from each expert on their respective topics. We will provide guiding questions for these introductory remarks specific to each barrier. For example, we will ask the panelist focusing on IRB coordination to address the broad IRB requirements for multi-institutional education research, how requirements differ based on study design or institution, approaches to add outside researchers to a primary institution’s IRB, and when it is necessary for all individual sites to go through IRB review. Following the statements by each panelist, the audience and moderator will ask questions. The moderator will explore specific panelist’s responses and will address issues relevant to multiple panelist’s topics.

Sponsors: 

The Collaboration of Surgical Education Fellows (CoSEF) is a multi-institutional collective of surgical residents focused on education research. CoSEF fosters inclusion through peer mentorship and resident-led research, addressing challenges in surgical education. Since its inception, CoSEF has facilitated multi-institutional research on topics such as virtual interviews, intern year challenges, the match process, gossip in residency, paths to leadership, and implicit bias. CoSEF’s success in inclusive research and multi-institutional projects makes us well-positioned to moderate this panel. Similarly, the Surgical Education Research Committee (SERC) supports multi-institutional research, providing grant support and facilitating collaboration and mentorship.

In a debate, participants actively engage with complex issues, learning by listening to where two ideologies come into conflict and circumstances where each side might be right. True extemporaneous debates rely on creativity and quick decision-making, as debaters analyze and argue various aspects of a topic. Debates encourage analyzing problems from multiple angles, fostering open-mindedness and adaptability. Often the conflict inherent to extemporaneous debating can allow debaters and the audience alike to explore and better understand the conflicting value systems inherent to contentious topics. In short, debating isn’t about winning the argument; it is about encouraging educators to think about controversial topics through a new lens and better understand both sides of an argument. To that end, CoSEF, in collaboration with the Communications Committee, proposes a Great Debate at Surgical Education Week. The debate will focus on a controversial topic within surgical education: the educational utility of pass/fail examinations and clerkship grades for medical students. By providing an opportunity for structured debate, we allow for inclusion and acknowledgement of multiple sides of the issue. These debates will frame the inclusive nature of Surgical Education Week, empowering attendees to keep an open mind on not only the topic debated, but on other topics throughout the meeting.

During this structured debate, which will follow a standardized debate format based on Lincoln-Douglas debate, residents will first provide prepared arguments in the form of opening statements for (Pro Team) and against (Con Team) a debate resolution (e.g., “double scrubbing surgical cases is an effective tool for teaching surgical residents”). These arguments will be crafted prior to the debate with input from attending debate coaches (one per team), selected for their expertise. Each team will then deliver extemporaneous rebuttals, improvised from their literature reviews prior to the debate, directly responding to arguments made in the opening statements. This structured exchange will clarify the core ideological conflict between the Pro and Con arguments, thereby deepening audience understanding of the issue. Between each round of arguments, cross examination will occur to allow each team to clarify their arguments. A moderator (a CoSEF member with experience in debate and panel moderation) will guide the audience through the debate, introducing each segment and keeping each team to strict timing. The debate will conclude with an audience Q&A led by the moderator, during which each team will take questions from the audience.

Often two contrasting ideologies can create entrenched but conflicting beliefs amongst surgical educators. In our experience, ‘debates’ held on controversial topics during national conferences often involve pre-planned presentations for and against the topic, without any substantial back-and-forth arguing of ideas. Our proposed “Great Debate” during Surgical Education Week will help engage educators to explore and gain new insight into the educational utility of pass/fail examinations and clerkship grades for medical students. Through structured rebuttals that foster direct, respectful engagement with opposing arguments, we hope the audience will reconsider previously held views, gain a deeper understanding of all sides of an issue, and make a more informed decision regarding this topic.

Artificial intelligence (AI) methods, including machine learning, hold tremendous promise to advance surgical education, offering new tools to enhance learning, improve skill acquisition, and personalize training for surgical trainees.  However, while the potential of AI in this space is vast, it also brings significant challenges that must be addressed to ensure successful and safe integration.

This panel session will explore the potential and the barriers that AI presents in surgical education. It will also present practical strategies for overcoming these challenges to create a more effective and inclusive learning environment for the next generation of surgeons. The discussion will be focused on the following topics

1. Application of AI in Surgical Education, current landscape : AI is being used in surgical education to augment traditional surgical training through automated performance analysis and feedback. The panel will highlight the potential with examples from undergraduate and graduate medical education.
2. Barriers to Implement AI in Surgical education: While AI holds promise, its integration into surgical education isn’t without hurdles. These include the need for large, high-quality data sets to develop AI models, concerns about the cost and scalability of AI technologies across institutions, gaps in obtaining funding to advance AI research in surgical education. The session will explore how educators can address these issues and make AI solutions more accessible.
3. Recent Advances in AI models including vision, synthetic data to augment training and LLM in surgical education (Innovation): The panel will highlight recent advances in various aspects of AI including GenAI, LLM and vision models as well as use of synthetic data generation for training.
4. Mitigating Bias in Training Data – Safe integration of AI in Surgical Education (Challenges): When developing and implementing AI in surgical education, one must be aware of the bias in data that is used for training. The panel will highlight various sources of bias and discuss strategies in mitigating them.

Targeted Audience:

ASE members with emphasis on

1. Surgical educators looking to incorporate AI into their curricula.
2. Medical students and surgical residents interested in how AI may shape their training.
3. AI researchers and developers working on healthcare applications.

The number of 4th year medical students applying into General Surgery Residency is at an all-time high. Surgery Clerkship Directors, Surgery Clerkship Coordinators, and Program Directors are often tasked with advising 4th year students applying into General Surgery. However, the advice disseminated varies from mentors and institutions across the country. The Clerkship Director Committee seek to present an open panel discussion consisting of Vice Chair of Education, Program Directors, Clerkship Directors, and Clerkship Coordinators to discuss best practices, current statistical trends, what traits/qualities programs desire, what resources are required, and challenging circumstances.  

Challenging circumstances include, but are not limited to, the following: 

• Poor academic performance 

• Couples matching 

• The pros and cons of taking a gap year 

• Dual applying into different surgical specialties 

• Not receiving enough interview offers 

• What is the right way to “SIGNAL” 

The target audience are for program directors, clerkship directors, clerkship coordinators, and medical students. We envision the session to be interactive with the audience and to spur a lively informative discussion.

We propose the following format: 

• There will be a moderator to introduce the panelist and the objectives of the panel.  (JUSTIN WAGNER- Vice Chair of Clerkship Director Committee)

• There will be 7 panelists/speakers from the Clerkship Director Committee. We chose our panelists to hopefully represent the diversity of training programs (i.e. Academic, Community, Rural, and Geographical Regions). 

• • Vice Chairs of Education 

• • Program Directors 

• • Clerkship Directors 

• • Clerkship Coordinators 

• Each panelist will present for 5-7 minutes to discuss different subjects based on current verified data and trends (i.e. ACGME, AAMC, LCME, etc.): 

• • Best Practices 

• • Resources Required 

• • Current Applicant Demographics and Statistical Trends 

• • Challenging Hot Topics  

• Moderator will start off the Q&A session with some prepared questions for the panelists.  

• The audience will also be encouraged to participate. 

At the end of the discussion, attendees should be able to gain a better understanding of the current application process and hopefully adopt best tips on how to advise applicants at their own institutions. Furthermore, our committee understand that the current national application process is imperfect and we hope that this will encourage our members to advocate, research, and continue to improve the general surgery application process.

Climate change is already impacting vulnerable populations worldwide and its negative effects on global health are set to become one of the greatest challenges of the 21^st century. The healthcare industry is responsible for 8-10% of carbon emissions in the United States, similar to the 10% contributed by the agriculture industry, and significantly higher than the 5.5% from the military. In order to avoid the worst effects of climate change, every industry will need to significantly decarbonize its activities to achieve a 45% reduction of carbon emissions by 2030 and reach net zero by 2050 – including healthcare. The operating room is particularly energy-intensive and wasteful compared to other areas in the hospital, creating an opportunity for improvement not available to others. As surgeons, we are ethically called to mitigate climate change as key stakeholders in the interventions that will reduce our carbon emissions.

Many of the interventions already being conducted to mitigate surgery’s impact on the climate are a response to advocacy from healthcare workers at an institutional level. However, there will be increasing incentives to integrate these projects more widely from professional bodies, regulators, and the general public. Sustainability has already been included as one of the domains of healthcare quality since the Institute of Medicine’s landmark report “Crossing the Quality Chasm: A New Health System for the 21st Century” and a more visible role of climate change in our everyday lives will expand this domain to include environmental sustainability.

As surgical educators, we have the opportunity to include environmental sustainability action as part of the non-procedural skills taught in surgical training. By building on the fundamentals of climate change covered during the 2024 annual meeting workshop: “A Surgeon’s Role in Mitigating Climate Change: Finding Opportunities to Reduce Carbon Emissions in Our Everyday Lives as Surgeons,” the proposed panel will present up-to-date evidence on the main sources of carbon emissions from surgical services and the interventions to mitigate them.  The target panel for this audience will be surgical educators and trainees.

Participants will leave the panel empowered with deeper knowledge of our impact on climate change and the role of surgical educators in training the next generation of environmentally-conscious surgeons.

The American Board of Surgery has mandated use of Entrustable Professional Activities (EPAs) in the assessment of general surgery residents since July 2023. EPAs compose a competency-based education (CBE) assessment framework that has been increasingly adopted across medical specialties as a workplace-based assessment tool. EPAs focus on directly observed behaviors to determine the level of entrustment a trainee has for a given activity of that specialty. Limited and emerging evidence of EPAs in general surgery has provided initial validity for their use. EPAs represent a current and significant shift in the evaluation of surgical residents as part of the overarching progression toward competency-based education among residency programs.

Nationwide implementation of EPA adoption and use has presented challenges across levels and stakeholders, including program directors, program coordinators, trainees, and front-line faculty. A first step in evaluating use and impact of EPAs on surgical education is to understand the initial implementation and, critically, perceived barriers experienced by stakeholders who have used this tool. Our objective is to investigate and describe the initial implementation and use of EPAs by general surgery programs and suggest tools, resources, and methods for overcoming initial barriers and obstacles.

Broadly, this panel of speakers will share challenges experienced at diverse programs and methods used to overcome them. We enlisted the perspective of various program types, including smaller community and larger academic institutions, as well as an overview of perspectives, including faculty, resident, and coordinator. We expect this session to be beneficial for educational leadership (e.g. Program Directors), general teaching faculty, residents, and program coordinators or managers. Although initially adopted by general surgery, this session should be useful across surgical specialties as this type of CBE continues to expand across surgical specialties.

This session will first provide an initial background on EPA implementation and use in general surgery for a broader audience, including background for adoption, logistics of implementation and use, and initial perceived obstacles. To this end, a survey of faculty and trainees (residents) was created to determine perceived barriers to using the EPAs. Introduction of this topic will also present initial findings from these surveys with suggested barriers and obstacles for discussion.

Critically, this session will also host four representatives who have experience with the implementation and use of EPAs at their program, including a faculty member from a smaller community program, a faculty member from a larger academic program, a resident, and a coordinator.

This collaborative, mixed-methods approach to understanding and exploring the impact of EPAs on surgical education will be of value to many members and attendees of ASE. After this session, attendees will be able to take home strategies to develop infrastructure for EPAs, enhance use of EPAs at their home program, understand barriers to initial implementation and use, and overcome those barriers via resources, tools, and ‘best practices.’

In this 60 minute panel, there will be a brief introduction by moderators from the ACE (Tasha Posid) and GSE (Kshama Jaiswal) committee to introduce the topic and importance, as well as a brief overview results from the ACE/GSE survey on EPA implementation.  This will be followed by 10-minute presentation for each panelist, followed by approximately 15 minutes for Q&A, lead by discussants Jenny Guido, Lisa Cunningham and Emily Huang.

Although the number of female surgical interns is approaching 50%, the lack of family-friendly policies and concerns about the feasibility of balancing the demands of a surgical career and family responsibilities continue to factor significantly into both medical students’ choice of career and the estimated 25% attrition rate of female surgical residents.  Roughly 35% of female surgeons who have completed residency since 2000 have opted to have children during their training (Frangou 2017), forcing program directors to adapt to accommodate more frequent family leave and lactation needs.  According to a 2018 study, a majority of female surgical residents worried about facing negative stigma during pregnancy, particularly if they needed a lighter schedule for their health or the health of their baby (Rangel). A recent survey of US surgical program directors also found that more than 60% believe motherhood adversely affects a trainee’s work and nearly half suggested that the research years are the optimal time for a woman to have a child.

Since July 2021, the American Board of Surgery has allowed greater flexibility for family leave by allowing a minimum of six weeks off once during training for either parental, caregiver, or medical leave without using vacation time or sick leave and without requiring an extension of time in training. Although this change in policy was an improvement, it does not provide adequate support for trainees who either have multiple pregnancies during training or experience complications during their pregnancy(ies).

Trainee concerns about potential pregnancy-related complications are justified. Existing data has shown that female surgeons tend to be older, have fewer children than their male counterparts and work significantly longer hours during pregnancy than the female partners of male surgeons.  Additionally, roughly 25% of female surgeon moms use assisted reproductive technology.  Female surgeons also have higher rates of C-section and pre-eclampsia and are more likely to experience postpartum depression than the female partners of male surgeons (Ranger, 2021).  Data has also shown that rates of obstetrical complications in residents increases markedly with more than 6 call nights per month and/or operating more than 8 hours per week—both extremely common occurrences for clinical surgical residents.

Following childbirth, lactation is an important concern for resident moms.  In a 2018 survey, a majority of female surgical resident mothers felt that having more accessibly lactation facilities would have allowed them to focus more on work and more than half either truncated breastfeeding or avoided it altogether, likely because a similar percentage witness derogatory comments about pumping or breastfeeding at work.  A significant minority felt comfortable asking their attendings to scrub out of a case to pump and many perceived that their attendings would mind if they did so (Rangel, 2018).

To promote a more inclusive workplace, surgical education leaders must continue to innovate to increase support for surgeon moms during and after pregnancy.  This panel will explore some of the current controversies and recommendations about family leave and lactation policies for trainees.

Financial well-being is a critical component of overall well-being for trainees. However, this aspect of well-being is often overlooked. Meanwhile, improved financial well-being is associated with significantly lower rates of burnout. This workshop will provide participants with the strategies, tools and information to implement effective, efficient, and action-driven financial education as well as tools for career transition within their GME curriculum.

Surgical training increasingly employs simulation for resident education. While simulations that use virtual environments or costly simulated tissue may be desirable to learners, they do not generally offer an advantage over low-fidelity models in task acquisition. In this workshop, participants will make three inexpensive models we created at our program: stoma, inguinal hernia, and pancreatojejunostomy. Participants will also learn how to develop new models for use in their own programs.

Clinical reasoning (CR) has been described as a core professional practice in medicine and a key component of all aspects of patient care (Young et al. 2022). Historically, research in CR was based on cognitive psychology theories that view reasoning as a process where information is received, processed and weighed within and individual’s mind, then used to select actions. This led to the articulation of cognitive frameworks like illness scripts and schemas that focus on diagnostic reasoning, in an effort to identify biases that lead to medical errors and threats to patient safety (Connor et al., 2020). These frameworks have been the basis on which CR is taught in many specialties of medicine.

Perhaps because of this focus on diagnostic over therapeutic decision making, surgical disciplines have largely been absent from this scholarship. Despite this, productive advances in our understanding of how surgeons make decisions have emerged, both pre-operatively and in the operating room, and during routine and non-routine cases (Cristancho et al. 2013, Cristancho et al. 2016,  Moulton et al. 2010, Zilbert et al. 2015). A central component of this research acknowledges that the context in which reasoning occurs (which surgeon, in what OR, with which team, and for which patient) is essential to understanding and teaching how to make the ‘optimal decision’. Recently, to better account for how clinicians and their environments interact and shape one another, a similar shift in the clinical reasoning literature has occurred. This perspective, adopted from the field of ecological psychology, seeks to understand reasoning as interactive and relational between an individual, their context, and the task at hand (Watsjold et al. 2022). In this lens, a surgeon brings particular effectivities (e.g. their knowledge and technical skills) to the clinical task, and the environment provides affordances (e.g. the patient’s anatomy, tools to complete the surgical procedure, and the staff available to assist) that interact to determine what can be achieved, thereby guiding or constraining a surgeon’s clinical reasoning in that specific context. Importantly, the ecological psychology view of clinical reasoning has not been applied to the surgical context.

In this workshop, we aim to introduce participants to this ecological perspective on clinical reasoning and discuss its relevance to research and teaching of clinical reasoning in surgery. Specific issues related to clinical reasoning in surgery will be reviewed, such as the role of anatomy knowledge in surgical decision making, the implication of skilled vs. unskilled assistants, planned vs. unplanned operative challenges, and the selection of specific surgical tools and operative approaches. Our goal is to demonstrate how this framework can be used in a practical way to guide teaching related to pre-operative planning, intraoperative decision making, and post-operative reflection for surgical trainees. In addition, we hope to engage in a discussion about how this framework can be used to ask novel questions about surgical reasoning, in hopes of establishing a research agenda for the future. We will review research methodologies that can help address these questions and will look to establish research collaborations with those who are interested to move knowledge in this area forward in the future.

Health inequities, although present throughout our healthcare system since its inception, have come to the forefront of medicine in recent years through the COVID-19 pandemic and Black Lives Matter movement in the United States. Strategies to mitigate racial and ethnic disparities in surgical care include diversifying the surgical workforce, which is essential for diversity and inclusivity, however, the surgical pipeline is long, and it will take decades for the surgical workforce to reflect the US population. To overcome this delay, we must concurrently provide cross-cultural training to meet our patients’ needs.

The ACGME requires health equity education and resident competency in communicating effectively with patients from various cultural backgrounds and with different language capabilities, however, there currently is not a formalized cultural competency curriculum that is implemented across all residencies. Cultural dexterity is an innovative paradigm shift from cultural competency training that transitions from one of understanding the importance of cultural influences on patients’ beliefs and behaviors to the cognitive and social skills needed to provide high quality, patient centered care.

The Provider Awareness and Cultural dexterity Toolkit for Surgeons (PACTS) trial, a NIH National Institute on Minority Health and Health Disparities R01 randomized crossover trial that took place at 8 academic surgical residency programs between 2019-2022, was developed to improve knowledge, skills and attitudes for surgical residents caring for patients of diverse cultural backgrounds. The PACTS curriculum mitigates disparities by focusing on surgical residents, and teaches them to recognize their biases, develop a set of tools to use in four key areas of surgical care, and empower them to engage in mindful encounters with diverse patients. The four key areas of focus are: 1) Building Trust and Effective Cross-Cultural Communication; 2) Optimizing Communication with Patients with Limited English Proficiency; 3) Informed Consent in Cross-Cultural Surgeon-Patient Relationships; and 4) Management of Pain in Cross-Cultural Surgical Care. These skills for situational awareness and adaptability in patient encounters are delivered through e-learning, case explorations, spaced learning, and clinical assessments of the surgical residents.

Results from the PACTS trial demonstrated improvement in resident knowledge, skills, and beliefs in cross-cultural care encounters, and positively impacted patients’ overall experience. Intended for both faculty and residents, this workshop trains facilitators on implementation of the PACTS curriculum in their own program. We will instruct attendees on the components of the PACTS curriculum and work through a case-exploration, emphasizing methods to adapt the curriculum to the specific needs of participants’ surgical training programs.

We spend a tremendous amount of effort addressing learners who need remediation in ACGME competencies, but we rarely focus on how to remediate faculty who are not realizing their full potential.  Many examples of challenging faculty scenarios exists: the yelling/screaming/ abusive attending, the disengaged attending, the attending who doesn’t let residents do any part of the operation, the attending who never turns in evaluations/EPAs – the list goes on.  In this scenario-based workshop, groups will formulate practical approaches to challenging faculty situations with implementation strategies.  Focus will be on tangible, take away plans.  Workshop faculty are experienced in navigating challenging, underperforming faculty scenarios.  We are looking forward to your insight and experiences.

The ASE recognizes that finding effective mentorship models is rare, even with the knowledge that mentorship significantly impacts personal and professional fulfillment, success, and development. A good mentor can change perspective, affect careers, and open opportunities, and we want to help provide you with the toolset for this! This workshop will introduce different mentorship models, discuss successful and unsuccessful strategies, and facilitate practicing skills in breakout groups.

The Surgical Innovation Master Class workshop is for surgeons and surgical residents interested in learning more about innovation principles and applying innovation skills at their home institution. This workshop will provide a comprehensive approach to fostering innovation in healthcare, focusing on empowering participants to lead innovation efforts, utilize institutional resources, and collaborate with multidisciplinary teams to drive meaningful change. This session introduces key innovation methodologies and equips participants with practical tools that can be immediately applied in their institutions.

The workshop covers Design Thinking, Creative Problem-Solving, and the Lean Startup Methodology, offering participants insight into how these frameworks can enhance problem-solving and drive clinical improvements. To strengthen multidisciplinary collaboration, participants will also be introduced to the Innovation Genome and the Competing Values Framework, equipping them with the tools to tackle complex surgical challenges through innovative thinking and team-based approaches. Additionally, the workshop will feature the novel Surgical Trainee Agile Innovation empoweRment (STAIR) framework, a hands-on approach to addressing early-stage innovation and quality improvement in the surgical environment.

We will begin with an introduction to core innovation principles, emphasizing the importance of collaboration, agility, and continuous feedback in driving improvements in patient care. Participants will then engage in a hands-on session to learn Design Thinking, using empathy mapping and journey mapping to better understand the needs of patients and healthcare teams while clearly defining clinical problems.

Next, the Creative Problem-Solving (CPS) session will introduce techniques like divergent thinking, mind mapping, and the SCAMPER method, tailored specifically to the healthcare environment. Surgeons and residents will explore how CPS can help them rethink surgical procedures, improve patient safety protocols, and streamline interdisciplinary communication. During this session, participants will also be introduced to the Innovation Genome and Competing Values Framework, which distill the DNA of breakthrough innovations, enabling participants to recognize key patterns for clinical solutions while leveraging the diverse skills of multidisciplinary teams.

In the second half of the workshop, participants will delve into the Lean Startup Methodology, learning how to apply rapid experimentation through the development of Minimum Viable Products (MVPs) in surgical practices. This session encourages teams to build, measure, and refine innovations quickly, ensuring their ideas can be applied effectively in real-world clinical settings. The STAIR framework will also be showcased through case studies that demonstrate how surgical trainees have used it to innovate clinical solutions during residency.

The workshop concludes with action planning, where participants will create personalized strategies to apply these methods within their surgical practices and home institutions, with the end goal to enhance patient outcomes, foster collaboration, and enhance a culture of innovation within academic surgery.

Surgical training favors right-handed surgeons, with most instruction and instruments designed for this population. There are limited resources for preparing opposite-handed surgeons to work together. We aim to discuss and demonstrate strategies that improve collaboration between opposite-handed surgeons.

This session is designed for both right- and left-handed surgeons, emphasizing collaboration and adaptability. Co-created with input from experts, the session features a hands-on simulation, small group discussions, and both in-person and video demonstrations of strategies that promote effective collaboration between surgeons with different dominant hands. We will also discuss some of the strategies used by learners and faculty to communicate and set expectations with one another about handedness. This will include skills for left-handed learners to communicate with right-handed faculty, as well as for left-handed faculty to communicate with right-handed learners.

We will begin by inviting participants to perform a surgical task using their non-dominant hand, providing firsthand experience of the challenges often faced by left-handed learners. This exercise will be followed by a group discussion, where participants can share their experiences and insights on operating with their non-dominant hand, as well as discuss anticipated or previously encountered challenges when working with opposite-handed surgeons. The session will then focus on practical strategies identified by the authors to enhance collaboration, supported by live demonstrations and video examples. Any new insights gained from this discussion will be used to shape and refine a formal curriculum.

By the end of this session, participants will have developed both practical and communication skills to enhance collaboration between right- and left-handed surgeons. These skills are intended to create a more inclusive learning environment for left-handed learners by helping right-handed faculty anticipate potential challenges and proactively address them. Additionally, left-handed trainees will gain strategies to effectively communicate their needs regarding handedness and to better navigate positioning and task execution in surgical settings.

Our multidimensional personal identities interact with our professional identities as surgeons and trainees to impact how we are perceived and perceive others in our work environments. Often, the lack of awareness of these identities can result in negative implicit bias toward colleagues and patients. Implicit bias is well-documented to impact health outcomes for patients and results in health and healthcare disparities via patient-clinical communication, clinical decision making, and institutionalized practices.

This DEI workshop leverages interactive learning techniques, including role-playing, paired discussions, and group debriefings, to facilitate a deeper understanding of implicit bias in clinical settings. The workshop is intended for surgical residents, surgical faculty, and program directors. It begins with self-reflection exercises, where learners examine their identities and potential biases using tools such as the Identity Wheel and the Wheel of Power/Privilege​. These activities help participants recognize blind spots in their awareness of how identity shapes interactions with patients and colleagues​. Thereafter, participants will engage in a clinical scenario where implicit biases influence decision-making, communication, and patient care. After this scenario, participants will engage in guided dyad and group discussions to reflect on their experiences, the biases they observed, and how these influenced their decisions. Finally, participants are exposed to the IDEAL framework, which teaches a structured approach to addressing bias in real-time. This model emphasizes the importance of recognizing bias, deciding to act, and effectively communicating to resolve the situation​.

Overall, this DEI workshop is designed to equip healthcare professionals with the tools to identify and confront implicit bias in clinical settings. By fostering self-awareness, encouraging reflection on personal and systemic biases, and practicing intervention techniques, the workshop aims to improve the quality of patient care and the inclusivity of healthcare environments. The immersive role-playing exercises and structured feedback loops help participants translate their learning into actionable steps that can be applied in daily practice.

This workshop was piloted at a single institution with surgical trainees with largely positive feedback. The long-term goals of this workshop includes expansion across surgical training programs. Our continued piloting of this workshop to a more expansive set of participants, including faculty and trainees through ASE will allow for generalizability across a diverse group of surgical educators. This workshop will give participants tools that can be shared within their respective institutions to promote surgical equity.

Summary:

This workshop aims to introduce surgical educators (residency program and clerkship directors, teaching faculty, educational psychologists, and surgical residents) to the applications of growth mindset in surgical training and equip them with the knowledge and skills needed to implement evidence-based growth mindset interventions for surgical trainees at their home institutions. 

Full Description: 

Mindset theory proposes that learners’ performance is influenced by not only knowledge and skill, but also unconscious beliefs about the malleability of personal attributes like talent or intelligence. Individuals with “fixed” mindsets consider such traits to be pre-determined, focus on performing well, and are more likely to give up when confronted with challenges; those with “growth” mindsets believe those traits can be improved, focus on developing skills, and are more persistent in their efforts (1).  Most people’s mindsets fall on a spectrum between the two and can change over time and in different circumstances.  Although mindset is well characterized in the broader education literature, it has only started to gain attention in the medical and surgical education community in the past few years (2).  Prior work has shown that growth mindsets may confer a host of benefits to surgical trainees including protection against burnout, improved resilience, and more positive responses to feedback (3).   

As such, there is a great opportunity for educators to promote and foster growth mindsets in their learners.  Studies of growth mindset interventions outside of medicine showed that even modest improvements can have meaningful, sustained impacts on performance (4).  While there are well-documented best practices on the structure of growth mindset interventions for various learner populations (5,6), this process is still challenging, as meta-analyses indicate that nearly half of interventions for college-age learners were ineffective (7).  Of note, while mindset is an individual trait, it is influenced by interpersonal and institutional factors (8).  Examination of mindset was an important component of the SECOND Trial, and there is increasing recognition that surgical educators must create environments that support growth mindset in their trainees (9, 10). 

This workshop begins by introducing mindset theory including key vocabulary, concepts, implications, and misconceptions.  Next, participants will participate in an abbreviated version of a growth mindset intervention developed and implemented for surgical interns at two major academic training programs in the Northeast and Southwest during the 2024-2025 academic year under the support of a 2024 ASE Foundation CESERT grant.  By closely reviewing the activities and understanding the rationale behind them, participants may appraise the intervention for potential application at their home institutions.  The final part of this workshop will further explore our experiences conducting the intervention, helping surgical educators anticipate challenges their learners may face in adopting growth mindsets during surgical training and develop strategies to overcome them.  Additionally, while not a primary objective, this workshop will afford an opportunity to discuss methods of studying mindset in the context of surgical training.  We hope that gathering a community of interested educators may support multi-institutional scale-up of teaching on mindset and research on the impact of mindset-focused interventions on surgical trainees.   

References

1. Dweck CS. Self-Theories: Their Role in Motivation, Personality, and Development. First. New York: Psychology Press; 1999. 212 p.
2. Coppersmith NA, Esposito AC, Yoo PS. The Potential Application of Mindset Theory to Surgical Education. J Surg Educ. 2022;79(4):845–9.  
3. Whaley Z. Examining the Mindsets of General Surgery Residents and Faculty. Harvard Medical School; 2023.  
4. Teunissen PW, Bok HGJ. Believing is seeing: How people’s beliefs influence goals, emotions and behaviour. Med Educ. 2013;47(11):1064–72.  
5. Yeager DS, Hulleman CS, Hinojosa C, Lee HY, O’Brien J, Romero C, et al. Using design thinking to improve psychological interventions: The case of the growth mindset during the transition to high school. J Educ Psychol. 2016;108(3):374–91.  
6. Heslin PA, Latham GP, VandeWalle D. The effect of implicit person theory on performance appraisals. J Appl Psychol. 2005;90(5):842–56. 
7. Sisk VF, Burgoyne AP, Sun J, Butler JL, Macnamara BN. To What Extent and Under Which Circumstances Are Growth Mind-Sets Important to Academic Achievement? Two Meta-Analyses. Psychol Sci. 2018;29(4):549–71.  
8. Osman NY, Sloane DE, Hirsh DA. When I say … growth mindset. Med Educ. 2020;54(8):694–5.  
9. Golisch K, Amortegui D, Mackiewicz N, Wu C, Cheung E, Bilimoria K, et al. Qualitative Identification of Mindset in General Surgery Trainees and Faculty in the United States. Global Surg Ed. 2024;3(1). 
10. Memari M, Gavinski K, Norman M. Beware False Growth Mindset: Building Growth Mindset in Medical Education Is Essential but Complicated. Acad Med. 2024;99(3):261-265.

Rapid Virtual Simulations (RVS) (Blanchard & Wiseman 2024) are technology-supported interactive learning experiences that are quick to create, deploy and modify and are repeatable, scalable and space and time-independent. Based upon Simon’s theory of “satisficing” these tools aim to provide learning impacts that are “good enough” rather than “perfect” and “complete”. RVS are designed to be “realistic enough”, aiming for functional task alignment rather than unnecessary “high fidelity” features that are cumbersome, complex, and expensive.

One example of an RVS is the “Deteriorating Patient App”, designed to help 4^th year medical students and first year residents practice the “ABCDEFG” approach to identifying, stabilizing and starting initial management for deteriorating post-operative hospitalized patients when on call. Deteriorating patients are important sources of morbidity and mortality and represent 5-20% of preventable hospital deaths. 28% of patients suffering an un-monitored cardiac arrest die and 60% of these patients show gradual deterioration of their vital signs for hours to days before they die.

Serious Games are learning activities in which learners participate in and contribute to a simulated clinical story with a deliciously uncertain outcome that best supports educational goals by providing learners with voluntary goals, roles, tasks, and rules by which they interact within an environment to make decisions or take actions leading to consequences within the game. (Wiseman 2016; Fullerton 2014).

In this workshop participants will compete in teams to solve Deteriorating Patient App scenarios using a modified “SimWars” (Okuda 2014) serious game approach. Participants will be able to take back to their institutions the tools, concepts and reflections needed to design or adapt their own RVS relevant to their learners’ needs.

Background:

A sense of professional identity, or alignment of professional roles, responsibilities, knowledge beliefs, and skills, is an essential component of developing in one’s surgical practice. However, competing priorities and interests in the healthcare field can at times make this alignment challenging.

As a higher portion of healthcare in US is delivered by large corporations, a higher proportion of surgical education is offered by surgeons who are not affiliated with an academic center.  Such professionals are involved with the education of close to 50% of our trainees and form about 30% of the membership of the Association for Surgical Education.  This group often struggle with professional identity and face unique challenges meeting the teaching and scholarly requirements of training programs while balancing ever present productivity concerns.

This workshop will focus on professional identity formation and challenges faced by the teaching faculty who are not directly associated with the universities.

Who should attend?

Educators who are part of Independent Academic Medical Centers, as well as all educators who are interested in this topic.

Structure of workshop:

• Large group session: sharing of stories of Professional Identity Formation and Challenges from members of the Independent Academic Medical Center Workgroup in the whole group format (15 min)
• Small group discussions: Facilitated discussions about identity formation and challenges (15 min)
• Wrap up and reflection (10 min)

Workshop schedule:

Intended Outcomes:

By the end of this workshop, participants will be able to:

• Appreciate the process of professional identity formation of teaching faculty at independent programs
• Understand challenges uncounted in fulfilling the requirements / teaching obligations as required by training programs
• Consider strategies to better align the roles of teaching faculty without compromising their productivity

Surgeons regularly face the difficult ethical challenge of supporting patients and families through high-stakes decisions as they consider burdensome treatments, e.g., major surgery and life-supporting treatments, in settings of serious illness and near the end of life. Our novel curriculum, called the Fundamentals of Communication in Surgery (FCS), aims to prepare all future surgeons to navigate these difficult treatment decisions with patients and their families. We are piloting the FCS curriculum at 5 institutions this academic year. For this workshop, we seek to bring a section of this curriculum to the broader audience of surgical education week.

Target audience: practicing surgeons, surgical trainees, and surgical educators. Anyone who interacts with patients will benefit from this curriculum.

Attendees will be able to practice and return to their institution to disseminate techniques of

1). Attending to emotion-Displaying empathy, avoiding the cognitive trap

2). Supporting patients in deliberation: Presenting the context, goals and downsides of surgery

Our training uses principles of adult education, minimizing didactics and focusing on drills and targeted practice with feedback. The FCS curriculum was developed by a team of surgeon educators from multiple institutions with interest in technical surgical skills education, advanced communication, ethics, and palliative care. Like dissection or suturing technique, communication with patients about surgery is a skill requiring performance, feedback, and repetition. This session will use improv techniques, card games, worksheets and role play to improve core communication skills.

Evidence suggests significant attrition (or a leaky pipeline) for trainees under-represented in medicine who have an interest in or pursue a career in surgery. As studies have investigated the pathway from undergraduate degrees to medical school, residency, fellowship, and academic medicine they have demonstrated that, at each step forward, there are fewer and fewer physicians who are women or with races/ethnicities that are under-represented in medicine. While the causes of these disparities are multifactorial, an underappreciated and correctable cause may be unconscious bias in assessment at all levels of medical and surgical training.

Implicit bias in standardized testing has long been discussed. Further, the recent transition of the USMLE Step 1 exam to pass/fail represents a highly publicized attempt to mitigate this bias. More recent evidence suggests that bias likely occurs in nearly all stages of medical assessment. Additionally, this bias may worsen feelings of imposter phenomenon and worsen stereotype threat – both of which may negatively impact the performance of women and trainees underrepresented in medicine, further perpetuating disparities in grading and academic recognitions. Therefore, the DEI, ACE, and GSE Committees propose a workshop to provide a framework for understanding bias in assessment and to train surgical educators to mitigate the impact of implicit bias by redesigning individual assessments and overall evaluation programs.

During this workshop, we will explain how the amplification of small disparities in trainee performance evaluation secondary to implicit bias can, over time, lead to significant differences in achievements and awards, contributing to role strain, stereotype threat, and imposter syndrome. Participants will practice redesigning a currently used trainee assessment to mitigate the likelihood of bias within that assessment. We will conclude by using a framework of components of equity in assessment (contextual, intrinsic, and instrumental equity) and the impact of bias at individual, interpersonal, and structural levels to frame a conversation about creating and redesigning trainee assessment.

From evidence of gender and racial bias within faculty letters of recommendation to the race-based differences present in examination scores such as the USMLE Step 1 and 2, bias is pervasive within medical student and resident recruitment. Implicit biases such as these stem from unconscious or involuntary judgments one makes toward a person based on an internalized stereotype, often coming from a lived experience. These biases are highly prevalent within medical education, such as is demonstrated in studies showing that staff surgeons prefer men in fields such as surgery and women in fields such as family medicine, and lead to discrimination toward trainees who are under-represented in medicine.

Implicit bias can be most impactful when making high stakes decisions, such as during resident and medical student recruitment. Comments such as “they just don’t fit our program” may mask an underlying implicit bias against the “other” or preference for an applicant who has shared characteristics with an interviewer, a phenomenon known as cloning. Further, over-reliance on inherently biased, seemingly objective assessments such as grades and test scores to screen applicants can result in less diversity within a medical school or residency program.

Trainee recruitment in medical education has undergone significant change over the past few decades, as medical schools and residency programs alike shift from a focus on grades and test scores to holistic review. In order to increase recruitment of diverse trainees in UME and GME as these changes occur, we must train our educators in effective strategies for mitigating the impact of implicit bias. Therefore, this workshop (co-sponsored by the DEI, GSE, and Faculty Development Committees) aims to give UME and GME leaders in education the tools they need to conduct effective holistic reviews of applicants while decreasing the implicit bias in selection committee meetings and decisions.

During surgery residency training, there is no formal financial literacy training, leaving many trainees unprepared for managing their finances when they transition to their first job as attending physicians. This lack of training can result in difficulties in understanding compensation systems, assessing the time value of money, and navigating the financial burdens and debts of residency and medical training. Laden with large amounts of debt and positioned to earn high salaries, many residents have limited financial experience and knowledge but are expected to navigate a difficult landscape of financial decisions with little time to research in the midst of an 80 hour work week. Residents, program directors, medical students, junior faculty, and any other stakeholders in resident training and physicians’ well-being are invited to attend this session on Financial Literacy Advancement and Resource Management for Surgeons.