Abstract
Decision-making is a vital part of surgical practice. Decision-making can be difficult to teach and learn at all levels of medical education, from undergraduate students to senior training registrars. Decision-making can also be a challenging process to teach, learn and use effectively in surgical hospital environments. The surgical environment is one with challenging hierarchies, a culture of differing to seniors, and relationships within and between teams that may modify the way students learn and experience decision-making. Cultural and social phenomena, such as expectations, assumptions, and norms of behaviour may offer affordances or impose constraints on the ways students can learn and clinicians can teach decision-making and impact how students become decision-makers. How students view and experience decision making may be quite different to what surgical registrars and surgeons believe they are doing when they are teaching and modelling the decision-making process. We hypothesis that how students experience the teaching and learning about decision making in their classrooms may be different from their experiences of teaching and learning in the surgical clinical environment. This environment includes surgical wards, operating theatres, and clinics.
We aim to examine the way undergraduate medical students, surgical registrars, and senior surgeons view their interactions with one another when they teach and/or learn decision making in the surgical environment and how these views and experienced may impact students’ experiences of learning decision-making in the surgical clinical environment.
The overarching research questions guiding this study are:
• How do undergraduate medical students/surgical registrars/senior surgeons view and experience teaching/learning decision-making in the surgical clinical environment?
• What cultural and social phenomena do each group report promoting/inhibiting/experiencing the teaching/learning decision-making in the surgical clinical environment?
• How might cultural and social phenomena impact teaching/learning decision-making in the surgical clinical environment for each group of learners/teachers?
Outcomes from this study will be findings that shed light on the hidden ways that students may learn and be taught to become surgeons and doctors. Findings may help educators to identify possible barriers in their workplace environment and design more effective ways to teach and help their students learn how to make decisions.
A sociocultural perspective will frame this qualitative study. We will explore how the interactions among medical student, surgical registrar, and senior surgeon may impact a student’s view and experience of learning decision making. We acknowledge that medical students do not only acquire skills and knowledge to become doctors. They are also participants who are shaped by and who are actively re-shaping the culture of learning defined by medicine and the individuals practicing medicine in surgical clinical environments. We therefore designed a semi-structured interview protocol to examine the views and experiences of surgical decision making by these three groups of learners/teachers.