Annals of the Royal College of Surgeons of England (I976) vol 58
Teaching postgraduate
surgery
Symposium held at the Royal College of Surgeons of England on the occasion of the Annual Meeting of Fellows and Members on ioth December 1975
AUDIOVISUAL AIDS IN TEACHING POSTGRADUATE STUDENTS G J Hadlield TD MS FRCS Chairman, Joint Audio-Visual Techniques Committee, Royal College of Surgeons
Audiovisual techniques are a useful addition to our methods of surgical teaching. Their role is complementary, augmenting but not replacing existing methods. The explosion of postgraduate personnel in Britain and abroad requiring teaching is not matched by sufficient staff to carry out teaching needs, or by accessibility of centres where this can be obtained. The ability to have the help of an expert lecturer on slide-tape in these circumstances enhances personal and small group study. All good lecturers constantly revise their material, rearrange it, and bring it up to date. The spoken word ages like the written word, and regular revision and updating has to be part of any slide-tape or other audiovistual programme. Some subjects may present special difficulty for the student in home study. At the College Dr Hill, of the Department of Anaesthetics in the Institute of Basic Medical Sciences, has julst finishecl preparing a videotape series for the measurement course. This will be of great value to postgraduates studying anaesthesia. In this College we regard basic science as an ongoing part of surgical training. A need for help in studying the underlying basic scientific principles in the Final examination has led to a series of slide-tapes being made by the College with this need in mind. Some nine tapes are ready for di-tribution through the Graves Foundation and others are in preparation. In clinical surgical training audiovisual methods have many uises. A direct recording
of a good clinical lecture with the slides copied is a feature of the service provided by the Midlands Recording Centre under the direction of Mr F G Hollands, of Derby. Few would disagree that operative surgery is best learnt by direct teaching, but it may not be possible to gather all the information in this way. A good teaching film in colour may be an acceptable substitute. It is often difficult for those not actually assisting to follow an operation, and for these other observers television relays are of great value. Videotapes can also be useful, but as they are as yet usually in black and white some argue that the other methods in colour are more realistic. Many candidates find it hard to gain an adequate knowledge of surgical pathology, often because a good museum is not easily accessible. While it is agreed that no method rivals the examination of the pathology of the living at endoscopy and operation, museum specimens have a useful place. At the College we are helping to solve this problem for the postgraduate by preparing a surgical pathology series of tape-slides. If audiovisual aids are to be used they must be easily available. For personal study a cassette player and slide viewer are required. These can be made up in the hospital or bought as a commercial unit. There are several of these on the market; two machines in common use are: a) Singer Caramate, Rank Audio-Visual, PO Box 70, Great West Road, Brentford, Middlesex TW8 9HR.
340 Teaching postgraduate surgery
b) Gordon Audio-Visual Carrel, 28/30 Market Place, Oxford Circus, London WiN 3PH. Every new item needs space for its use and it will soon be necessary for centres to put aside a room for this work. It is suggested that these should be divided into listening booths for private study with adequate cupboard space to store the slides and tapes. Such a facility could become a subsection of the library under the care of the librarian. The following bodies supply audiovisual aid packs: i) Medical Recording Service Foundation,
Kitts Croft, Writtle, Chelmsford CMI 3EH, Essex. 2) BLAT Centre for Health and Medical Education, BMA House, Tavistock Square, London WCi 9JR. 3) Midlands Recording Centre (Mr F G Hollands FRCS), Royal Infirmary, Derby. Apart from these many regions have their own collection of films, videotapes, and slide-tapes. The fear that machinery will replace man in teaching is unfounded and there will always be a demand for the skilled teacher. We should, however, explore the possibilities where his skill can be used to the best advantage at a time when it is in short supply.
THE ART OF LECTURING Robert Ollerenshaw ERD TD DL FRCS Director, Department of Medical Illustration, University of Manchester.
The formal lecture preserves a very ancient tradition derived from the extreme scarcity and expense in earlier days of textbooks from which the student might teach himself. The form of lecturing, essentially didactic and designed (according to one well-known and rather unkind description) to transfer facts from the notes of the lecturer to the notebook of the student without going through the mind of either, has changed little over the years, although its popularity as a method of teaching is undoubtedly on the wane. The view that the lecture is outdated and unnecessary is not new; Samuel Johnson considered that 'lectures were once useful, but now, when all can read and books are numerous, lectures are unnecessary'. His view is not unsupported today. Without argument, the lecture is the most difficult educational tool; the really good lecturer is probably born, like a good artist in any art. I did not choose my title, 'The art of lecuring', but I would not quarrel with it. Personally, I do not like lecturing,, for I am not a 'natural'. Everyone in medicine can think of the naturals-Osler, Jefferson, Aird, their names come readily to mind, and the list does not necessarily correlate with that of the great medical writers. Reading is more leisurely and
the reader can pause when he wishes; at a lecture the listener is captive so that the onus of establishing contact is with the lecturer. Jeffermn may be remembered for two dicta on lecturing: 'Make it so simple the cat can understand it' and, even more to the point, 'Obscurity is not a sign of greatness'. But very few of us are naturals and many of us will be faced with the duty of lecturing with or without the modem armamentarium of socalled visual aids, which can only too often become visual booby-traps. The inexpert may improve his expertise by practice; this need not be live every time and the tape recorder is a valuable and very revealing critic. For the beginner there are methods of cheating. Bright is reputed to have carried notes for his parliamentary speeches in his top hat. Mark Twain wrote key letters on his fingernails but came to grief when he lost count of the ones he had licked off. The teleprompter, unless one is a trained newsreader, can be a highway to disaster. An American president once threw in a substantial aside in one of his TV interviews, only to come back to the teleprompter to find that it was several jumps ahead of him. He never did catch up and the event was a disaster. Completing the list of
Teaching postgraduate
surgery
Symposium held at the Royal College of Surgeons of England on the occasion of the Annual Meeting of Fellows and Members on ioth December 1975
AUDIOVISUAL AIDS IN TEACHING POSTGRADUATE STUDENTS G J Hadlield TD MS FRCS Chairman, Joint Audio-Visual Techniques Committee, Royal College of Surgeons
Audiovisual techniques are a useful addition to our methods of surgical teaching. Their role is complementary, augmenting but not replacing existing methods. The explosion of postgraduate personnel in Britain and abroad requiring teaching is not matched by sufficient staff to carry out teaching needs, or by accessibility of centres where this can be obtained. The ability to have the help of an expert lecturer on slide-tape in these circumstances enhances personal and small group study. All good lecturers constantly revise their material, rearrange it, and bring it up to date. The spoken word ages like the written word, and regular revision and updating has to be part of any slide-tape or other audiovistual programme. Some subjects may present special difficulty for the student in home study. At the College Dr Hill, of the Department of Anaesthetics in the Institute of Basic Medical Sciences, has julst finishecl preparing a videotape series for the measurement course. This will be of great value to postgraduates studying anaesthesia. In this College we regard basic science as an ongoing part of surgical training. A need for help in studying the underlying basic scientific principles in the Final examination has led to a series of slide-tapes being made by the College with this need in mind. Some nine tapes are ready for di-tribution through the Graves Foundation and others are in preparation. In clinical surgical training audiovisual methods have many uises. A direct recording
of a good clinical lecture with the slides copied is a feature of the service provided by the Midlands Recording Centre under the direction of Mr F G Hollands, of Derby. Few would disagree that operative surgery is best learnt by direct teaching, but it may not be possible to gather all the information in this way. A good teaching film in colour may be an acceptable substitute. It is often difficult for those not actually assisting to follow an operation, and for these other observers television relays are of great value. Videotapes can also be useful, but as they are as yet usually in black and white some argue that the other methods in colour are more realistic. Many candidates find it hard to gain an adequate knowledge of surgical pathology, often because a good museum is not easily accessible. While it is agreed that no method rivals the examination of the pathology of the living at endoscopy and operation, museum specimens have a useful place. At the College we are helping to solve this problem for the postgraduate by preparing a surgical pathology series of tape-slides. If audiovisual aids are to be used they must be easily available. For personal study a cassette player and slide viewer are required. These can be made up in the hospital or bought as a commercial unit. There are several of these on the market; two machines in common use are: a) Singer Caramate, Rank Audio-Visual, PO Box 70, Great West Road, Brentford, Middlesex TW8 9HR.
340 Teaching postgraduate surgery
b) Gordon Audio-Visual Carrel, 28/30 Market Place, Oxford Circus, London WiN 3PH. Every new item needs space for its use and it will soon be necessary for centres to put aside a room for this work. It is suggested that these should be divided into listening booths for private study with adequate cupboard space to store the slides and tapes. Such a facility could become a subsection of the library under the care of the librarian. The following bodies supply audiovisual aid packs: i) Medical Recording Service Foundation,
Kitts Croft, Writtle, Chelmsford CMI 3EH, Essex. 2) BLAT Centre for Health and Medical Education, BMA House, Tavistock Square, London WCi 9JR. 3) Midlands Recording Centre (Mr F G Hollands FRCS), Royal Infirmary, Derby. Apart from these many regions have their own collection of films, videotapes, and slide-tapes. The fear that machinery will replace man in teaching is unfounded and there will always be a demand for the skilled teacher. We should, however, explore the possibilities where his skill can be used to the best advantage at a time when it is in short supply.
THE ART OF LECTURING Robert Ollerenshaw ERD TD DL FRCS Director, Department of Medical Illustration, University of Manchester.
The formal lecture preserves a very ancient tradition derived from the extreme scarcity and expense in earlier days of textbooks from which the student might teach himself. The form of lecturing, essentially didactic and designed (according to one well-known and rather unkind description) to transfer facts from the notes of the lecturer to the notebook of the student without going through the mind of either, has changed little over the years, although its popularity as a method of teaching is undoubtedly on the wane. The view that the lecture is outdated and unnecessary is not new; Samuel Johnson considered that 'lectures were once useful, but now, when all can read and books are numerous, lectures are unnecessary'. His view is not unsupported today. Without argument, the lecture is the most difficult educational tool; the really good lecturer is probably born, like a good artist in any art. I did not choose my title, 'The art of lecuring', but I would not quarrel with it. Personally, I do not like lecturing,, for I am not a 'natural'. Everyone in medicine can think of the naturals-Osler, Jefferson, Aird, their names come readily to mind, and the list does not necessarily correlate with that of the great medical writers. Reading is more leisurely and
the reader can pause when he wishes; at a lecture the listener is captive so that the onus of establishing contact is with the lecturer. Jeffermn may be remembered for two dicta on lecturing: 'Make it so simple the cat can understand it' and, even more to the point, 'Obscurity is not a sign of greatness'. But very few of us are naturals and many of us will be faced with the duty of lecturing with or without the modem armamentarium of socalled visual aids, which can only too often become visual booby-traps. The inexpert may improve his expertise by practice; this need not be live every time and the tape recorder is a valuable and very revealing critic. For the beginner there are methods of cheating. Bright is reputed to have carried notes for his parliamentary speeches in his top hat. Mark Twain wrote key letters on his fingernails but came to grief when he lost count of the ones he had licked off. The teleprompter, unless one is a trained newsreader, can be a highway to disaster. An American president once threw in a substantial aside in one of his TV interviews, only to come back to the teleprompter to find that it was several jumps ahead of him. He never did catch up and the event was a disaster. Completing the list of
