Simulation in paediatric urology and surgery. Part 1: An overview of educational theory

Surgical training has changed radically in the last few decades. The traditional Halstedian model of time-bound apprenticeship has been replaced with competency-based training. Advanced understanding of mastery learning principles has vastly altered educational methodology in surgical training, in terms of instructional design, delivery of educational content, assessment of learning, and programmatic evaluation. As part of this educational revolution, fundamentals of simulation-based education have been adopted into all levels and aspects of surgical training, requiring an understanding of concepts of fidelity and realism and the impact they have on learning. There are many educational principles and theories that can help clinical teachers understand the way that their trainees learn. In the acquisition of surgical expertise, concepts of mastery learning, deliberate practice, and experiential learning are particularly important. Furthermore, surgical teachers need to understand the principles of effective feedback, which is essential to all forms of skills learning. This article, the first of two papers, presents an overview of relevant learning theory for the busy paediatric surgeon and urologist. Seeking to introduce the concepts underpinning current changes in surgical education and training, providing practical tips to optimise teaching endeavours.