SCTA and modern forms of training
SCTA and modern forms of training
“See one, do one, teach one” is the classical organization of training, and an improvement with respect to “learning by doing”. We have observed a total change in medical education during the last decades. Nowadays physicians are thought to be competent in every respect before they see a patient.
There seems to be a gap between 0 and 100 or a contradiction between the needs of a physician and that of a patient. The competent – taught – physician is being assumed. Teaching has to be a matter far from the patient – no-touch-teaching. But how can that be accomplished or how can education be organized under these demands ?
The standard-model of a physician is a person that is motivated to take care of patients and thus has the best basis for self-controlled and problem-oriented learning, two central segments of adult learning.
He/she is reluctant to bother or even harm patients and tries to follow modern aspects of distant medical learning, which comprises reading and e-learning – including the use of 3-D-animation or virtual reality in addition to simulator training:
· Simulator training – in operative skills. It is either hands-on for coordination training between eyes and hands, like the Laparoscopic Skills Training & Testing (LASTT®) or Suturing Skill Training and Testing method (SUTT®), HYSTT psychomotor skills or the E-Knot – home trainer.
· Simulator training – in obstetric skills. Every student learned obstetrics using Birth-Training-Models. These passive models became refurbished to be used for normal delivery, breech delivery, shoulder dystocia or vaginal operative deliveries vacuum and forceps. The achievements of electronics and new ideas are being realized in a bunch of new models including some for Caesarean-section.
· Simulator training – last but not least – in diagnostic skills, like Ultrasound-Simulators.
The principles of adult learning are important prerequisites for a successful training:
1. self-controlled and •
2. problem-oriented learning, in a setting of
3. teamwork and
4. on the-job learning – after certified basic simulator training.
From the Trainer perspective, the 4 steps approach of the Royal College of Surgeons marks a basis for effective training:
1. demonstration trainer demonstrates at normal speed
2. deconstruction trainer demonstrates while describing steps
3. comprehension trainer demonstrates while learner describes steps
4. performance learner demonstrates while learner describes steps
Taking into account that work-life-balance, family life and other private aspects of life play a greater role in career planning than in former times, new working models have to be offered. In the actual plans the basis of medical and specialist education is a defined amount of time of work in specified institutions. In the near future the ends of years will be replaced by defined competence – comprising theoretical, practical, and communicative skills. The final certificate will then be based on a competence based assessment. This means that a significant amount of competence – especially theoretical knowledge – can be gained at home, outside the hospital, in courses, as guest, or by e-learning.
Providing choices of where to gain competence, the possibilities should also be open for different learning styles for e.g. auditory, visual , tactile or kinesthetic learners for a task- or problem-oriented learning of adults.
In the end of these modernised processes full of choices, the personalities of teachers and learners will play an even greater role than in formalized situations.
Thus, intellectual and motor skills, knowledge, cognitive strategies, learn how to learn, diligence, patient safety and doing right , but also attitudes and ingenuity will be in the focus for a well trained specialist.
Whenever anybody should think, this might be the end, continuing professional development – CPD – will follow life-long with its
· Short term aims, like • Maintenance of knowledge and skills • Improvement of knowledge and skills • Learning new knowledge and skills
· Long term aims, like • Improvement of performance, and last but not least, • Improvement of patient care.
Chair: Dr Angelique Goverde
Members: Tahir Mahmood, Jacky Nizard, Rolf Kirschner, Peter Hornnes, Fedde Scheele, Klaus Vetter, André Van Assche, Juriy Wladimiroff, Johannes Bitzer, Ziva Novak Antolic, Anna Aabakke
Subspecialties: Anis Feki (ESHRE), Rainer Kimmig (ESGO), Gerard Visser (EAPM), Stefano Salvatore (EUGA)
Societies: Simon Leeson (EFC), Joe Jordan (EFC), Pekka Nieminen (EFC), Yves Van Belle (ESGE), Carlos Damonte Khoury (ISPOG), Milko Sirakov (EURAPAG), Paul Wood (EURAPAG)