The view from here
Early specialty courses and the spiral of learning Philip McElnay, Education Centre, Bristol Royal Infirmary, Bristol, UK
T
he ‘spiral of learning’ employed in medical education involves revisiting topics on a number of occasions. On each occasion, the complexity of the topic increases and a student’s understanding deepens.1 This concept is employed between the Foundation Skills in Surgery (FSS) course, coordinated by the Association of Surgeons in Training, and the Intercollegiate Basic Surgical Skills (BSS) course, coordinated by the Royal College of Surgeons. The former I attended as a medical student, and the latter as a junior doctor. Both courses consist of small group sessions. Both discuss basic knowledge of sutures, drains and instruments. Both have practical sessions, allowing candidates to practise hand and instrument ties, simulated excision of cysts and suturing skills on animal models.
Yet, despite their similarities the two courses are aimed at two different levels of experience, and were two distinct points on my spiral of learning. Studies have demonstrated that introducing medical students to concepts and skills required in surgery at an early stage in their career have positive outcomes: they have a more constructive experience of their surgical placement,2 and their ability to perform simple surgical procedures is improved.3 This was certainly the case for me. I had no surgical knowledge prior to attending the FSS course, but it provided me with the basic knowledge and skills I needed to attend theatre as a medical student. Having physically practised hand tying on a skin model, I was able to understand the steps undertaken by the highly skilled senior surgeons operating in front of me. I didn’t spend half an hour learning how
to scrub when I went to theatre, because I had practised it in a simulated environment. As such I was able to not only observe, but to participate in all stages of the operation. My spiral began with the FSS course. The faculty members were patient in helping me to develop a basic understanding of surgical reasoning. I could then use the experiences around me in hospital as learning opportunities instead of being stumped by initial simple concepts. My spiral of surgical skill, experience and knowledge continued to deepen.
The ’spiral of learning’ employed in medical education involves revisiting topics on a number of occasions
The BSS course, which I attended 5 years later, had a similar format and thus acted as a further steep learning curve on my spiral of learning. After 4 years of experience between the courses and innumerable learning opportunities, I was able to quickly consolidate the basics
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My only criticism is that it is not widely publicised that the courses work synergistically. Like many junior doctors, I learn from experience and I am grateful that an educationally focused surgeon encouraged me to go on a course as early as second year at medical school. It has transformed the way I have learned and continue to learn. (This also goes to show that you should listen to your mentor – another great resource in surgical education!)
Early attendance at such courses can really kick-start a spiral of learning that will continue throughout a doctor’s life
being taught and focus on more complex procedures.
Early attendance at such courses can really kick-start a spiral of learning that will
continue throughout a doctor’s life. REFERENCES 1.
Harden RM. What is a spiral curriculum? Med Teach 1999;21:141–143.
2.
Antiel RM, Thompson SM, Camp CL, Thompson GB, Farley DR. Attracting students to surgical careers: preclinical surgical experience. J Surg Educ 2012;69:301–305.
3.
Davis CR, O’Donoghue JM, McPhail J, Green AR. How to improve plastic surgery knowledge, skills and career interest in undergraduates in one day. J Plast Reconstr Aesthet Surg 2010;63:1677–1681.
Corresponding author’s contact details: Dr. Philip McElnay, Education Centre, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK. E-mail: [email protected]
Funding: None. Conflict of interest: None. Ethical approval: Ethics approval has not been sought. No study has been carried out. doi: 10.1111/tct.12111
314 © 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 313–314
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5/23/2014 3:09:33 PM
Early specialty courses and the spiral of learning Philip McElnay, Education Centre, Bristol Royal Infirmary, Bristol, UK
T
he ‘spiral of learning’ employed in medical education involves revisiting topics on a number of occasions. On each occasion, the complexity of the topic increases and a student’s understanding deepens.1 This concept is employed between the Foundation Skills in Surgery (FSS) course, coordinated by the Association of Surgeons in Training, and the Intercollegiate Basic Surgical Skills (BSS) course, coordinated by the Royal College of Surgeons. The former I attended as a medical student, and the latter as a junior doctor. Both courses consist of small group sessions. Both discuss basic knowledge of sutures, drains and instruments. Both have practical sessions, allowing candidates to practise hand and instrument ties, simulated excision of cysts and suturing skills on animal models.
Yet, despite their similarities the two courses are aimed at two different levels of experience, and were two distinct points on my spiral of learning. Studies have demonstrated that introducing medical students to concepts and skills required in surgery at an early stage in their career have positive outcomes: they have a more constructive experience of their surgical placement,2 and their ability to perform simple surgical procedures is improved.3 This was certainly the case for me. I had no surgical knowledge prior to attending the FSS course, but it provided me with the basic knowledge and skills I needed to attend theatre as a medical student. Having physically practised hand tying on a skin model, I was able to understand the steps undertaken by the highly skilled senior surgeons operating in front of me. I didn’t spend half an hour learning how
to scrub when I went to theatre, because I had practised it in a simulated environment. As such I was able to not only observe, but to participate in all stages of the operation. My spiral began with the FSS course. The faculty members were patient in helping me to develop a basic understanding of surgical reasoning. I could then use the experiences around me in hospital as learning opportunities instead of being stumped by initial simple concepts. My spiral of surgical skill, experience and knowledge continued to deepen.
The ’spiral of learning’ employed in medical education involves revisiting topics on a number of occasions
The BSS course, which I attended 5 years later, had a similar format and thus acted as a further steep learning curve on my spiral of learning. After 4 years of experience between the courses and innumerable learning opportunities, I was able to quickly consolidate the basics
© 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 313–314 313
tct_12111.indd 313
5/23/2014 3:09:31 PM
My only criticism is that it is not widely publicised that the courses work synergistically. Like many junior doctors, I learn from experience and I am grateful that an educationally focused surgeon encouraged me to go on a course as early as second year at medical school. It has transformed the way I have learned and continue to learn. (This also goes to show that you should listen to your mentor – another great resource in surgical education!)
Early attendance at such courses can really kick-start a spiral of learning that will continue throughout a doctor’s life
being taught and focus on more complex procedures.
Early attendance at such courses can really kick-start a spiral of learning that will
continue throughout a doctor’s life. REFERENCES 1.
Harden RM. What is a spiral curriculum? Med Teach 1999;21:141–143.
2.
Antiel RM, Thompson SM, Camp CL, Thompson GB, Farley DR. Attracting students to surgical careers: preclinical surgical experience. J Surg Educ 2012;69:301–305.
3.
Davis CR, O’Donoghue JM, McPhail J, Green AR. How to improve plastic surgery knowledge, skills and career interest in undergraduates in one day. J Plast Reconstr Aesthet Surg 2010;63:1677–1681.
Corresponding author’s contact details: Dr. Philip McElnay, Education Centre, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK. E-mail: [email protected]
Funding: None. Conflict of interest: None. Ethical approval: Ethics approval has not been sought. No study has been carried out. doi: 10.1111/tct.12111
314 © 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 313–314
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5/23/2014 3:09:33 PM
