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      Teaching to transform surgical culture: an educational programme and thematic analysis in a general surgery department

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          Abstract

          Introduction

          General surgery departments are busy, meaning educational opportunities may be sporadic. Clinical priorities can sometimes supersede teaching and trainees may feel alienated at the periphery of the working community. In this study, we demonstrate how a reflective, multidisciplinary general surgery teaching programme was established and use this to assess the impact of structured teaching on surgical doctors of all grades in the department.

          Methods

          Twelve semi-structured telephone interviews were conducted with participants of varying grades. Transcripts were analysed using a grounded theory thematic analysis, revealing four themes: the value of teaching; learning as a community; barriers to successful training; and culture of surgery.

          Discussion

          Teaching helped juniors construct healthy narratives around general surgery and encouraged a process of professional identity formation. Pairing junior and senior colleagues allowed both to develop their skills, and reflective learning revealed new learning opportunities. Transparency across the ‘community of practice’ was achieved and the programme helped juniors overcome negative stereotypes of intimidation embedded in the hidden surgical curriculum.

          Conclusion

          Reflective, multidisciplinary learning can challenge the hidden curriculum and encourage team cohesion. A commitment to critical reflective teaching will be vital in cultivating surgeons of the future.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12909-022-03941-3.

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          Most cited references26

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          Social cognitive theory: an agentic perspective.

          The capacity to exercise control over the nature and quality of one's life is the essence of humanness. Human agency is characterized by a number of core features that operate through phenomenal and functional consciousness. These include the temporal extension of agency through intentionality and forethought, self-regulation by self-reactive influence, and self-reflectiveness about one's capabilities, quality of functioning, and the meaning and purpose of one's life pursuits. Personal agency operates within a broad network of sociostructural influences. In these agentic transactions, people are producers as well as products of social systems. Social cognitive theory distinguishes among three modes of agency: direct personal agency, proxy agency that relies on others to act on one's behest to secure desired outcomes, and collective agency exercised through socially coordinative and interdependent effort. Growing transnational embeddedness and interdependence are placing a premium on collective efficacy to exercise control over personal destinies and national life.
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            CONSTRUCTING PROFESSIONAL IDENTITY: THE ROLE OF WORK AND IDENTITY LEARNING CYCLES IN THE CUSTOMIZATION OF IDENTITY AMONG MEDICAL RESIDENTS.

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              Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83.

              There are many theories that explain how adults learn and each has its own merits. This Guide explains and explores the more commonly used ones and how they can be used to enhance student and faculty learning. The Guide presents a model that combines many of the theories into a flow diagram which can be followed by anyone planning learning. The schema can be used at curriculum planning level, or at the level of individual learning. At each stage of the model, the Guide identifies the responsibilities of both learner and educator. The role of the institution is to ensure that the time and resources are available to allow effective learning to happen. The Guide is designed for those new to education, in the hope that it can unravel the difficulties in understanding and applying the common learning theories, whilst also creating opportunities for debate as to the best way they should be used.
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                Author and article information

                Contributors
                madhavdave@doctors.org.uk
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                23 January 2023
                23 January 2023
                2023
                : 23
                : 51
                Affiliations
                [1 ]GRID grid.498924.a, ISNI 0000 0004 0430 9101, Division of General Surgery, , Manchester University NHS Foundation Trust, ; Oxford Road, Manchester, M13 9WL UK
                [2 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Department of Surgery and Cancer, , Imperial College London, ; London, UK
                Article
                3941
                10.1186/s12909-022-03941-3
                9869620
                36690994
                2e7f61e0-c93d-422f-8680-26f4c244123d
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 21 March 2022
                : 19 September 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2023

                Education
                medical education,postgraduate education,general surgery,hidden curriculum,multidisciplinary,thematic analysis

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