The operating theatre as a classroom: a literature review of medical student learning in the theatre environment

Stefanie M. Croghan,William Howson,Catherine Phillips

doi:10.5116/ijme.5ca7.afd1

Abstract

ObjectivesWe set out to review the published literature relating to the educational experiences of medical students in the operating theatre. In particular, we wished to deduce from the current evidence what challenges are posed to student learning in this environment, and how they may be overcome. MethodsNational Library of Medicine and Google Scholar databases were searched from 1990-2018, using search terms ‘Operating Theatre,’ OR ‘Operating Theater,’ OR ‘Operating Room’ AND ‘Medical Students.’ Title and abstract review of 679 papers were performed. Full-text English language papers about the learning or satisfaction of medical students in the theatre environment were included. Papers exploring the experiences of residents/trainees rather than medical students were excluded. A total of 36 papers were eligible for inclusion. Thematic analysis was conducted on these papers. ResultsA number of common themes were identified. Throughout the literature, medical students describe a lack of clear learning objectives, fear, anxiety, feelings of humiliation and intimidation, lack of visualisation and lack of opportunity for participation as barriers to their satisfaction with theatre placements and to their subjective learning. ConclusionsObstacles identified by students as deleterious to their experiences in the operating theatre are remarkably reproducible across a number of research studies in different populations. Areas to address by both individual educators and curriculum designers include fostering a culture of inclusion in theatre, setting explicit, achievable learning goals for students in this environment and making a concerted effort to prepare students for the theatre setting.

Highlights

Surgical exposure is incorporated into the curriculum of virtually all medical schools, and widely considered a necessary component of the undergraduate experience
By becoming more cognisant of the obstacles faced by medical students, we propose that eduators can work at both altering the milieu to make it more inviting, and at equipping students with the skills necessary to navigate the surgical environment
A critical narrative approach was used in this literature review, with the intent of systematically identifying and synthesizing the published literature related to the learning of medical students in the operating theatre environment

Summary

Introduction

Surgical exposure is incorporated into the curriculum of virtually all medical schools, and widely considered a necessary component of the undergraduate experience. As a learning environment, operating theatres have many resources to be exploited. Changing the teaching domain (e.g. from classroom to outdoors) is recognised within education as potentially beneficial.[1] introducing the medical student to the novel theatre environment may incite interest and heighten the senses. Theatre naturally offers multimodal stimuli, and is inviting to students of all learning styles: visual, auditory, read/write and kinaesthetic.[2] The traditional aim of improving clinical/exam-related performance is addressed, but students gain an understanding of surgical specialities, learn about “surgical culture,” and may be inspired in future career choice. . “Going to theatre gives [students] a better understanding of surgery than [they] get just reading the textbooks.”[5] The traditional aim of improving clinical/exam-related performance is addressed, but students gain an understanding of surgical specialities, learn about “surgical culture,” and may be inspired in future career choice.3, 4 “Going to theatre gives [students] a better understanding of surgery than [they] get just reading the textbooks.”[5]

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Conclusion