A review of UK undergraduate surgical curricula and teaching methods with an analysis of the university of Dundee (2011–2021)

Abstract

• There is insufficient undergraduate surgical teaching in the UK. • Inconsistent teaching has led to severe shortfalls in many surgical specialties. • Simulation based learning has become an essential pillar of surgical education. • Studies typically measure subjective student-reported confidence in taught skills. • The university of Dundee runs successful BSS and theatre etiquette sessions. This review discussed the current state of undergraduate surgical education in UK medical schools with focus on changes over the previous decade (2011–2021). An analysis of theatre etiquette and basic surgical skills (BSS) courses from the University of Dundee undergraduate curriculum was also undertaken, with comparison to the literature. A PubMed search using the quire “(undergraduate) AND (medicine) AND (Surgical) AND (teaching) AND (UK)” returned 155 publications. These were screened for relevance to yield the 100 publications discussed in this review. Analysis of student feedback (2016 – 2019) was carried out for BSS and theatre etiquette courses. There exists a lack of consensus around the undergraduate curricula with extreme variation in teaching and clinical exposure by speciality and medical school. These are aided by the widespread adoption of simulation-based learning and non-technical skills teaching. Most teaching is conducted in transitional programmes to prepare students for surgical attachments with skills teaching focused on fourth- and fifth-year students. Scrubbing, gowning, gloving, and suturing are all often taught briefly and inconsistently with little follow up. A wide variety of novel techniques including near peer assisted, targeted basic surgical skills (BSS) courses and student opportunities, including mentorship and conferences have been found to be effective but are often limited to a single institution. Consensus amongst the existing literature highlights an urgent need for reform of surgical education to ensure patient safety and graduate competency. The University of Dundee runs a theatre etiquette and BSS courses which produces results which indicate a high degree in confidence subjective outcomes. There is a wealth of subjective and non-specific data with infrequent objective comparison between modern teaching modalities. The deficiency of undergraduate surgical teaching presents an opportunity to re-establish curricula using significantly more effective non-technical, near-peer, and simulation teaching modalities.