The Teacher-Learner Contract (TLC): An Objectives-Based Checklist for Surgical Shadowing

Area of Science:

• Medical Education
• Surgical Training
• Health Professions Education

Background:

• Physician shadowing offers valuable learning opportunities for medical students.
• Current shadowing experiences often lack structure and clear communication, limiting their educational impact.
• A structured approach is needed to maximize the benefits of shadowing for both students and supervising physicians.

Purpose of the Study:

• To evaluate the effectiveness of an objectives-based surgical shadowing teacher-learner contract (TLC).
• To assess the impact of the TLC on communication and learning outcomes in shadowing experiences.
• To determine the perceived usefulness and usability of the TLC by students and surgeons.

Main Methods:

• A cross-sectional study involving 30 student-surgeon pairs.
• Participants engaged in a 1-time surgical shadowing experience between December 2016 and May 2017.
• Preclinical medical students and surgeons from various specialties in Metro Vancouver were recruited.

Main Results:

• The TLC improved focus and communication between students and surgeons.
• Students reported enhanced reflection on learning goals and the role of shadowing in their medical education.
• Both students and surgeons found the TLC useful (mean scores >3.5/5) and easy to use (mean scores <1.5/5); 80% would use it again.
• Students with less shadowing experience and surgeons with less teaching experience benefited most.

Conclusions:

• An objectives-based learning contract, such as the TLC, can foster more meaningful surgical shadowing experiences.
• The TLC has the potential for longitudinal educational benefits for medical trainees.
• Widespread adoption of such contracts requires institutional support and integration into medical training programs.