The philosophy of “see one, do one, teach one” guided training of surgical residents for more than 100 years. The adage refers to the medical tradition of residents learning a surgical technique by observing it once before being expected to perform it independently the next time and eventually teach it to a surgeon in training.
However, recent trends such as work-hour restrictions and increased complexity of surgical techniques have made learning basic skills in the OR a less-workable option. In addition, there is increased recognition by both the public and surgical community that allowing novices to do too much may not be beneficial for the patient.
The General Surgery Residency Program at Washington University School of Medicine was one of the first surgical training programs in the country to introduce a surgical skills lab. The lab starts with “boot camp” for surgical interns, teaching suturing and basic skills at the beginning of the first year, and then extends to residents in all years of the training program.
As residents gain more experience, the sessions involve more complex skills so the sessions are divided into junior level (laparoscopic cholecystectomy, for example) and senior level (laparoscopic nissen fundoplication). The program also has laparoscopic and endoscopic simulators. The WUSM Institute for Surgical Education (WISE) serves as the center for technical skills training outside of the operating room. WISE provides endoscopic, laparoscopic and robotic simulators, as well as cadaver dissection labs for practicing specific surgical procedures.
Sessions are taught by the program director, general surgery and other faculty members representing a broad spectrum of specialties and senior residents.