Surgeon and trainee perspectives on intraoperative education: a systematic review and meta-synthesis

This study aims to understand the perspectives of surgeons and trainees on intraoperative surgical education, identifying perceived barriers and facilitators. Surgical training is shifting towards competency-based medical education (CBME) with the goal of graduating measurably competent surgeons. Despite this, concerns remain that trainees lack the clinical exposure to develop surgical competency. Understanding surgeon and trainee perspectives on intraoperative education can help identify current issues and provide direction for improving surgical training. A systematic review and meta-synthesis of qualitative studies that assess surgeon and trainee perspectives of intraoperative education was performed. 11,287 papers were screened, and 60 met the inclusion criteria, representing the perspectives of 1592 surgeons and trainees. Three major themes emerged that emphasised (1) the importance of developing trust, (2) the key qualities of effective surgeon educators, and (3) the impact of financial incentives, medico-legal concerns and educational support in the educational environment. This review provides a framework to understand intraoperative education and identifies key facilitators and barriers for surgeons, trainees and training programs.