Ten tips for teaching in the theatre tearoom: shifting the focus from teaching to learning.

Educational encounters between surgeons and trainees are often brief, spontaneous, opportunistic events. In spite of their vast teaching experience, very few surgeons have had educational training that enables them to optimise such opportunities. This article reviews the literature on medical education and adult learning, and makes practical suggestions about how surgeons can best help trainees to learn. The most important ideas, such as creating a supportive learning environment, actively engaging the learner, and providing constructive feedback, are relevant to any teaching and learning, but are particularly applicable to informal, on-the-job educational encounters such as teaching in the theatre tearoom.

How assessment drives learning in neurosurgical higher training.

UNLABELLED: Certifying the competence of neurosurgeons is a process of critical importance to the people of Australia and New Zealand. This process of certification occurs largely through the summative assessment of trainees involved in higher neurosurgical training. Assessment methods in higher training in neurosurgery vary widely between nations. However, there are no data about the 'utility' (validity, reliability, educational impact) of any national (or bi-national) neurosurgical training system. The utility of this process in Australia and New Zealand is difficult to study directly because of the small number of trainees and examiners involved in the certifying assessments. This study is aimed at providing indirect evidence of utility by studying a greater number of trainees and examiners during a formative assessment conducted at a training seminar in Neurosurgery in April 2005. AIM: To evaluate an essay examination for neurosurgical trainees for its validity, reliability and educational impact. METHODS: A short answer essay examination was undertaken by 59 trainees and corrected by up to nine examiners per part of question. The marking data were analysed. An evaluation questionnaire was answered by 48 trainees. Eight trainees who successfully passed the Fellowship examination who had also taken the short essay examination underwent a semi-structured interview. RESULTS: The essay examination was found to be neither reliable (generalisability coefficient of 0.56 if the essay paper had comprised 6 questions) nor valid. Furthermore, evidence suggests that such an examination may encourage a pursuit of declarative knowledge at the expense of competence in performing neurosurgery. CONCLUSION: This analysis is not directly applicable to the Fellowship examination itself. However, this study does suggest that the effect of assessment instruments upon neurosurgical trainees' learning strategies should be carefully considered.

The neurosurgical training curriculum in Australia and New Zealand is changing. Why?

The Neurosurgical Advanced Training curriculum of the Royal Australasian College of Surgeons (RACS) is currently undergoing change. Given the high standard of neurosurgery in Australia and New Zealand, it may be questioned why such change is necessary. However, the curriculum has not kept pace with developments in professional practice, educational practice or educational theory, particularly in the assessment of medical competence and performance. The curriculum must also adapt to the changing training environment, particularly the effects of reduced working hours, reducing caseloads due to shorter inpatient hospital stays and restricted access to public hospital beds and operating theatres, and the effects of sub-specialisation. A formal review of the curriculum is timely.

Self-directed learning in population health. a clinically relevant approach for medical students.

BACKGROUND: In this article, we describe the education model used to integrate population health learning into a new 4-year medical program at the University of Sydney. METHOD: Our two-pronged approach aims to prepare third-year students to integrate population health thinking into their day-to-day clinical reasoning and to equip them with skills to investigate specific population health topics. We provide an example of a student-led, small-group session on health issues for disadvantaged populations, along with an outline of our assessment and evaluation methods. This innovative course illustrates one approach to the challenge of motivating students to bridge the gap between their interest in the medical care of individual patients and the healthcare needs of whole populations. RESULTS/CONCLUSIONS: Students performed adequately in the assessments required for progression to the next year of the program. Students rated the case-based exercises; self-directed learning; on-line and library resources; tutor facilitation; and student-led, small-group sessions as effective methods for learning.