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Am J Surg. 2019 Feb;217(2):281-287. doi: 10.1016/j.amjsurg.2018.10.037. Epub 2018 Nov 1.

See one, do one, teach one: A randomized controlled study evaluating the benefit of autonomy in surgical education.

Author information

1
Vanderbilt University Medical Center Department of Surgery, 1161 21st Avenue South D4313 MCN, Nashville, TN, 37232-2730, USA. Electronic address: mtleco01@gmail.com.
2
Vanderbilt University Medical Center Department of Surgery, 1161 21st Avenue South D4313 MCN, Nashville, TN, 37232-2730, USA. Electronic address: melissa.k.stewart@vanderbilt.edu.
3
University of Arkansas for Medical Sciences, College of Medicine, 4301 W Markham St #550, Little Rock, AR, 72205, USA. Electronic address: TJHarris@uams.edu.
4
University of Arkansas for Medical Sciences, College of Medicine, 4301 W Markham St #550, Little Rock, AR, 72205, USA. Electronic address: grives@uams.edu.
5
Vanderbilt University Medical Center Department of Surgery, 1161 21st Avenue South D4313 MCN, Nashville, TN, 37232-2730, USA. Electronic address: Christy.m.guth@vanderbilt.edu.
6
Vanderbilt University Medical Center Department of Surgery, 1161 21st Avenue South D4313 MCN, Nashville, TN, 37232-2730, USA. Electronic address: jesse.ehrenfeld@vanderbilt.edu.
7
University of Arkansas for Medical Sciences, Department of Surgery, Division of Acute Care Surgery, 4301 W Markham St, Little Rock, AR, USA. Electronic address: kevin.sexton@uams.edu.
8
Vanderbilt University Medical Center Department of Surgery, 1161 21st Avenue South D4313 MCN, Nashville, TN, 37232-2730, USA. Electronic address: kyla.terhune@vanderbilt.edu.

Abstract

INTRODUCTION:

"See one, do one, teach one" has represented the model for surgical education for over a century, however recent changes in education have reduced autonomy in training. The goal of this study was to assess the impact of autonomy on learning a procedural skill.

METHODS:

Senior medical students were randomized and trained to performance a vascular anastomosis utilizing progressive autonomy vs. constant supervision. Performance was tested using videotaped technical grading and anastomotic pressure testing.

RESULTS:

Mean baseline performance times and technical ratings were similar in both groups. Final completion times was faster in the autonomy group, 14:03min vs. 19:09min (p = 0.02). Final technical ratings were similar, 40.0 vs. 39.2points (max = 50), for each group and both demonstrated similar improvement in leak test against a standardized sample.

CONCLUSION:

Teaching a procedure, as a final step in graded autonomy, results in superior performance in timing while maintaining equal technical performance compared to trainees with less autonomy.

KEYWORDS:

Autonomy; Simulation; Surgical education; Teaching

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