Correspondence

Teaching Surgical Skills

N Engl J Med 2007; 356:1381March 29, 2007

Article

To the Editor:

Reznick and MacRae (Dec. 21 issue)1 report on the current status of simulation in surgical-skills training and its various applications. Another potential use of simulation is as a part of the curriculum for medical students, with an aim to introduce hands-on skills training and evaluation early in their career. During surgical clerkships, only 67% of surveyed students thought that the surgical teaching and exposure they had received was adequate,2 and the majority of the exposure involved minor, “less risky” parts of surgical procedures, such as tying knots or cutting sutures. Perhaps the exposure of students to surgical simulation would allow them to appreciate their own technical ability, would reveal whether they were interested in participating in technical procedures, and would therefore influence their choice of residency training.

Vani Dandolu, M.D.
Jordan Newmark, M.D.
Temple University Hospital, Philadelphia, PA 19140

2 References

1. 1

   Reznick RK, MacRae H. Teaching surgical skills -- changes in the wind. N Engl J Med 2006;355:2664-2669
   Full Text | Web of Science | Medline

2. 2

   Ek EW, Ek ET, Mackay SD. Undergraduate experience of surgical teaching and its influence on career choice. ANZ J Surg 2005;75:713-718
   CrossRef | Web of Science | Medline

Author/Editor Response

Drs. Dandolu and Newmark outline another potential application of training using surgical simulation. Although our article concentrated primarily on postgraduate training, we wholeheartedly agree that undergraduate students also benefit from training in a surgical-skills laboratory setting. In our institution, a trial program of skills training was implemented at one of the four major teaching academies. Other students demanded to be included, and we now offer laboratory-based skills training to every medical student at the beginning of the surgical clerkship. This type of training benefits not only future surgical residents but also all future physicians who require technical skills in their practice.

We would like to address one other issue relating to our article. Since its publication, we have heard from several colleagues who have correctly pointed out that William Stewart Halsted, the great American surgeon, was never knighted.

Helen MacRae, M.D.
Richard Reznick, M.D.
University of Toronto, Toronto, ON M5G 1L5, Canada
richard.reznick@utoronto.ca