The Future of Surgical Education Research

(Note:  Cross-posted from the AAS Blog)

April 10-12 was the annual meeting of the Association for Surgical Education (ASE). This meeting brings together those with a significant interest in surgical education, and the highlight of the ASE meeting is always the level of scholarship that is now being brought to the field of surgical education research. As someone who has been involved with ASE since my residency, and who completed the Surgical Education Research Fellowship (SERF) program over a decade ago, the ever-expanding diversity and depth of education research is exciting and timely. For many years, being a surgical educator mostly implied being a teacher, and for some it also subsumed administrative roles with clerkships or residencies. In more modern terms, being a surgical educator now means that someone is a teacher, an administrator, and a researcher.

Deb DaRosa, a former ASE President and a distinguished PhD surgical educator, provided arguably the most motivational talk of the meeting in which she provided us with a call to advance a more ambitious research agenda in surgical education. She challenged us to work to establish an infrastructure for identifying and studying “mega-trends” in education that require investigation. She encouraged the ASE to have an annual RFP for systematic reviews. Dr. DaRosa also encouraged us to find ways to cultivate extramural funding sources to support critical education research issues. Most importantly, she reminded us of the importance of continuing to improve the scientific rigor and the diversity of methods used in surgical education research. The meeting program certainly reflected an important trend in this direction; in particular, more qualitative research was presented at the ASE this year than in any year to date.

Within the ASE, the Multi-institutional Education Research Group (MERG) is already doing important work in this direction. This group became a “full” ASE committee just one year ago, but has already completed a Delphi process to identify key issues in surgical education that merit multi-institutional studies. The “Top 10” list identified in this manner includes the following items:

  1. What are the performance criteria a resident has to meet to be considered competent and before independent practice is allowed?
  2. Which are the best methods to assess resident performance and competence (intraoperative, and clinical, procedural, and cognitive)?
  3. What are the best milestones and assessment methods to determine if a resident should be promoted to the next PGY year?
  4. What are the most effective methods to improve faculty teaching ability and promote interest in teaching?
  5. What is the level of perceived and actual readiness of graduating residents for independent practice?
  6. Which is the best method to identify and remediate residents with poor cognitive, technical, or behavioral skills?
  7. What is the optimal method to provide intraoperative teaching and feedback to residents and how is it best assessed?
  8. Will the incorporation of the ACGME/ RRC milestones in residency training improve training quality and the skill of graduating residents?
  9. What are the most common deficiencies in the training of general surgery residents and fellows?
  10. Which is the best training modality (simulation, animal or cadaver models, or combination thereof) for the optimal acquisition of surgical skill by residents outside the operating room?


MERG also has a systematic review of multi-institutional surgical education research studies published in the last decade under way, with submission for publication anticipated later in 2014. This group is taking leadership in setting the agenda for surgical education research, and I anticipate ongoing exciting developments through their efforts.


As more links are established between education and patient quality and safety, the interplay of educators with our colleagues in other areas of surgery will become ever more important. This change will also mandate ever-increasing rigor in the study of our educational interventions. This year’s ASE meeting provided an excellent sampler of ways in which surgical education research is becoming a vibrant discipline, and one conducive to a rich academic surgical career.