Teaching Ward Round Research Articles

Application of Health Education Accurately Linking System combined with case-based leaning in nursing teaching ward round in the encephalopathy clinic

Application of Health Education Accurately Linking System combined with case-based leaning in nursing teaching ward round in the encephalopathy clinic

The undergraduate virtual grand teaching ward round: Perceptions from the subcontinent.

Background Grand ward rounds are an integral component of undergraduate medical education. Covid-19 prevented the conduct of conventional grand ward rounds (CWRs) prompting a 'virtual' grand ward round (VWR). With restrictions lifted should future grand ward rounds remain virtual? Undergraduate perceptions on the two formats were sought to explore the feasibility of the VWR as a teaching ward round for medical students. Methods Our study was done during April 2021 to April 2022. The weekly grand ward round was converted to a VWR during April-November 2021. Following lifting of restrictions, it was reverted to a CWR. All patients provided informed consent. A Zoom-based, secure, online platform was created with the use of smartphones to share audiovisuals and patient discussions. An online anonymised feedback survey was conducted for undergraduates during both VWR and CWR phases. Results The response rate was 71% (182/258). VWR was considered more advantageous than the CWR in terms of time efficiency (p=0.03), space restrictions (p=0.01), improved audibility (p=0.02) and better opportunity to engage in discussions (p=0.1). Most students (80%) felt that the VWR provides a more 'ideal' grand ward. Overall preference was towards VWR across safety (92%), efficacy (72%), communication (85%), information availability (84%) and training opportunity (73%). Again 80% of students preferred future ward rounds to be virtual. Conclusions VWR is an innovative approach. While not a substitute for bedside teaching it appears safer, efficient, thought/discussion-provoking and more satisfactory. Successful elements of the VWR can be adopted in future, to develop a more ideal undergraduate grand ward round.

The application of the BOPPPS model in the ward rounds of nurses' standardized training in Southwest China: a mixed methods study.

Teaching ward rounds are the main teaching method used to develop clinical skills in standardized nursing training. However, the existing methods lack of cultivation of comprehensive ability and humanistic care for nurses, cannot meet the requirements of standardized training for nurses. BOPPPS (bridge-in, objective, pre-assessment, participatory Learning, post-assessment, and summary) is a student-centered teaching model that has been proven to enhance classroom teaching effectiveness. Therefore, the BOPPPS model was applied and its effectiveness in standardized nursing training was evaluated. In total, 260 nursing students were randomly allocated to two groups: the experimental group used the BOPPPS model and the control group used the traditional teaching model. This study used a mixed quantitative and qualitative research method to evaluate the effectiveness of the BOPPPS model. The quantitative results were as follows: no significant difference in baseline scores was observed between the two groups before training. After training, the theory and practical scores in the experimental group were significantly higher than that of the control group. Similarly, students in the experimental group presented higher comprehensive ability scores than their counterparts. The students in the experimental group also exhibited higher satisfaction compared to the control group, while there was no difference in teacher satisfaction scores between the two groups (p = 0.323). Qualitative data showed that the vast majority of nurses and teachers agreed on the value of BOPPPS training. Compared to traditional teaching methods, the BOPPPS model was more effective in standardized nursing training. We recommend applying the BOPPPS model to nursing training.

A57Simulated Practice as a Method to Promote Legitimate Peripheral Participation

Simulated sessions are widely used within medical education. Despite the potential benefits of simulated learning, it suffers from a narrow scope of practice; acute, emergency presentations and procedural skills. There is less research for its utility in sub-acute and chronic disease management. To develop expertise in medical practice, learners require sufficient foundational knowledge to facilitate more complex behaviours [1]. Within ward environments, lack of foundational knowledge in both ‘hard’ (knowledge) skills, and ‘soft’ (organizational) skills can limit learners’ potential for development. Considering legitimate peripheral participation theory, learners require ‘enculturing’ into an institution to develop ‘soft’ skills. Examples of ‘soft’ skills include understanding problem solving approaches, language, values and norms of the profession [2]. To design and assess the educational impact of simulated ward round teaching sessions on medical students in semi-acute settings, focussing on ‘enculturing’ skills. This was a prospective study. We created a ward round-based simulation session, with six simulated patient scenarios, designed for clinical placement level medical students. Ten students were included in the study. We utilized an induction exercise to familiarize students with medical documentation, a simulated ward round, and a consolidation exercise reviewing discharge paperwork and prescriptions. A simulated patient was present in each scenario, with a member of faculty facilitating. Simulated ward round entries, nursing handover queries and investigations were provided to students. Scenarios were 20 minutes; with objectives to produce ward round documentation and generate holistic clinical management decisions. Students participated in a ‘board round’, which served as a forum for station specific feedback. Enculturing values were assessed via a 40-point, knowledge based formative assessment, covering the main themes of the session: appropriate documentation, medical abbreviations, and clinical decision-making. Assessment was administered both pre- and post-session. Qualitative feedback of the session was obtained from learners to identify themes for further development. There was a significant improvement in knowledge following the session (see Results of pre- and post-intervention knowledge assessment Our results demonstrate an increased sense of empowerment in the study population. Simulated practice can be used effectively to enhance learning in sub-acute medical situations. Enculturing skills were particularly enhanced; promoting future learning through orientation within zones of legitimate peripheral participation. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Determinants of satisfaction and self-perceived proficiency of trainees in surgical residency programs at a single institution

BackgroundWe aimed to identify factors contributing to training program satisfaction and self-perceived proficiency of residents in 5 integrated surgical residency programs within the same referral institution.MethodsWe conducted a cross-sectional survey including all senior surgical residents in all integrated sub-specialty and general surgery residency programs at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. Training programs were assessed on 6 educational components including operative case volume and diversity, intra-operative hands-on training, morning teaching sessions, seminars, ward rounds, and research opportunities.ResultsOf 82 eligible residents, 69 (84.1%) responded to the survey. Overall resident satisfaction (rated from 0–10) varied between the 5 training programs, from a mean of 6.03 to 7.89 (overall p = 0.03). The percentage of residents who agreed they would be proficient by the end of their training ranged from 44.2%-88.9%. General surgery residents had the lowest overall satisfaction score, and lowest scores in all educational components except seminar teaching. In multivariable analysis, operative case volume and diversity (AOR 3.67; 95% CI, 1.24–10.83; P = 0.019), and hands-on training (AOR 4.15; 95% CI, 1.27–13.5; P = 0.018) were significantly associated with overall resident satisfaction. In ordinal logistic regression, hands-on training (OR 3.94, 95% CI, 1.69–9.2; P = 0.001), and seminar sessions (OR 2.43, 95% CI, 1.11–5.33; P = 0.028) were significantly associated with self-perceived proficiency.ConclusionDifferent surgical residency training programs within the same institution had divergent resident satisfaction scores and proficiency scores. Operative case volume and diversity, and intraoperative hands-on training are the most important predictors of resident satisfaction while hands-on training and seminar sessions independently predicted self-perceived proficiency. Attention to these key components of resident education is likely to have a strong effect on training outcomes.

Medical Ward Round Teaching: A Mixed Methods Study to Explore the Perspective of Junior Doctors

Aim: To evaluate the educational value of the ward round in medicine and allied wards for junior doctors and identify the barriers to effective learning during a round. Methodology: This mixed-method study was conducted over six months in the medicine and allied units of Ayub Teaching Hospital, Abbottabad. A semi-structured online questionnaire consisting of five and six point Likert-type scale responses was administered to 172 house officers and junior residents and data recorded through Google Forms. Data was analyzed by SPSS version 25.0 for descriptive statistics. The quantitative part was triangulated for validation with seven in-depth interviews from purposively selected participants which were thematically analyzed after assigning codes, categories and subthemes. Results: The response rate was 76.7%. The most important skill acquired during ward round was development of an approach towards patients 60(45.5%). This was followed by learning presentation skills 56(42.4%) and patient management 52(39.3%). Majority of the participants identified bed-side overcrowding 90(68.1%) to be the greatest barrier in learning during a round. Content analysis of the qualitative part suggested that an improvement in learning could be achieved by reducing the number of participants, introducing structured checklists and removing distractions for a consultant. Conclusion: Ward round is perceived to be an important tool for learning in medical education by junior doctors, but its full potential is not being utilized. Improvements can be made by changes made in the ward environment and structuring rounds by leading physicians. Keywords: Medical education, teaching rounds, physicians, learning

The First Clinic of Surgery in Lithuania and its Founders

The developement of surgery in Vilnius and Lithuania is related to the Vilnius University Clinic of surgery founded in the middle of 1808–1809 academic year, that is more than 200 years ago and it was the first specialized clinical institution of the Grand Duchy of Lithuania. This new chapter at the Faculty of Medicine was orientated to the teaching and training of surgeons and developing their scientific approach to clinical practice. The Clinic of Surgery took over the concept of clinical education from the Clinic of Therapy which was initiated by Johan Peter Frank (1745–1821) and Joseph Frank (1771–1842) 3 years earlier. They were the founders of Vilnius medical Society as well. The concept consisted of the integration of basic theoretical knowledge into clinical skills learning. The basis of clinical training was ward round teaching on patient’s bedside, round the clock duty in the Clinic, continuous observation of patients and taking part in autopsy. Further developments of the Clinic were related to the activities of surgical professors from Western Europe, as well as highly experienced local doctors who immediately started lecturing and operating patients. These were the creators, developers and cherishers of the Clinic: Jacque Briotet (1746–1819), Johan Andreas Lobenwein (1758–1820), Johan Friedrich Niszkowski (1774–1816), Jakób Szymkiewicz (1775–1818), Konstantin Porcijanka (1793–1841). Foundation and successful operation of the surgical clinic signified a higher level in the evolution of Lithuanian clinical medicine. New concept of teaching and scientific approach to the diagnosis and surgical treatment made the clinic comparable to the European innovative medical institutions of the 19th century. The effective activities and future prospects were roughly cut off by Russian tsarist policy in 1832.

Live streaming ward rounds using wearable technology to teach medical students: a pilot study

BackgroundThe COVID-19 pandemic resulted in a loss of clinical clerkship opportunities for medical students. To address this problem while maintaining patient safety, this pilot study explored the feasibility of using...

A remote access mixed reality teaching ward round.

Heterogeneous access to clinical learning opportunities and inconsistency in teaching is a common source of dissatisfaction among medical students. This was exacerbated during the COVID-19 pandemic, with limited exposure to patients for clinical teaching. We conducted a proof-of-concept study at a London teaching hospital using mixed reality (MR) technology (HoloLens2™) to deliver a remote access teaching ward round. Students unanimously agreed that use of this technology was enjoyable and provided teaching that was otherwise inaccessible. The majority of participants gave positive feedback on the MR (holographic) content used (n=8 out of 11) and agreed they could interact with and have their questions answered by the clinician leading the ward round (n=9). Quantitative and free text feedback from students, patients and faculty members demonstrated that this is a feasible, acceptable and effective method for delivery of clinical education. We have used this technology in a novel way to transform the delivery of medical education and enable consistent access to high-quality teaching. This can now be integrated across the curriculum and will include remote access to specialist clinics and surgery. A library of bespoke MR educational resources will be created for future generations of medical students and doctors to use on an international scale.

An assessment of surgical curriculum on “practical year” by students of Pomeranian Medical University in Szczecin

Abstract Introduction: Modifications to teaching medicine introduced 5 years ago consisted of abolishing the internship, changing the surgical curriculum in the last year of studies by introduction of a so called “practical year”. The objective of this study was investigating how the practical year was undertaken at the Pomeranian Medical University in Szczecin in the academic year 2017/2018. Materials and methods: A study was carried in a group of 154 students of the 6th year of Faculty of Medicine, just before the final test-exam in surgery. The questionnaire used in the study consisted of 11 closed questions concerning the organization, course, and accomplishment of the provided program. Results: The questionnaire results show that the assumed aim of the curriculum, which was a skill/competency-oriented teaching of surgery, was half executed. Students were insufficiently engaged in typical doctor’s activities. One-half of them considered their practical-year as no different from classes practiced in the previous years. Ward-round teaching and the performance of manual skills was considered the most valuable portion of the surgical curriculum. Seminars were scored the lowest, as the least useful. Organization of the classes and the engagement of tutors were evaluated positively by the majority of students. The results of this survey show the grade of accomplishment of the assumed educative aims in teaching surgery in the practical year, and have revealed some drawbacks, which should translate into an improvement of teaching in the forthcoming years.

Challenges and Problems of Clinical Medical Education in Iran: A Systematic Review of the Literature

Context In order to improve the quality of clinical education, it is necessary to investigate the current situation in clinical settings and identify its problems. This step is the most important part of modifying a clinical education program and meeting learning goals. The purpose of this study was to identify the challenges and problems of clinical medical education in Iran. Evidence Acquisition This systematic review was performed to determine the challenges and problems of clinical medical education in Iran in 2017. In order to retrieve articles, the following keywords: Clinical education, bedside teaching, clinical teaching, teaching round, ward round, ward round teaching, bedside round, teaching round, medical education, clinical round, ambulatory education, clinic education, grand round, and education in emergency were searched in reliable Persian and English databases. Then, the articles related to the research objective were carefully reviewed and key information was extracted. Data were analyzed using MAXQDA software version 10. Conclusions The problems of clinical education are in different areas. Identifying these areas and planning for them can improve clinical education status, achieve educational goals, and provide medical students with a more effective education.

Application of clinical nursing teaching model based on Mini-Clinical Evaluation Exercise in teaching rounds of nursing students

Objective To explore the application effect of Mini-Clinical Evaluation Exercise(Mini-CEX) in clinical teaching rounds of nursing students, and to provide reference for improving the quality of clinical teaching. Methods A total of 120 nursing students from June 2017 to June 2018 were divided into control group and intervention group by the time of practice with 60 cases each. The control group adopted traditional nursing teaching rounds, while the intervention group adopted Mini-CEX-based nursing teaching rounds. The comprehensive results of nursing students′practice, Mini-CEX and autonomous learning ability of the two groups were compared and analyzed. Results The overall evaluation of Mini-CEX of nursing students was (7.23 ± 0.51) in the intervention group and (5.27 ± 1.12) in the control group, and the difference was statistically significant (t=12.337, P <0.01). The excellent rate of nursing students was 58.3%(35/60) in the intervention group and 30.0%(18/60) in the control group, and the difference was statistically significant (χ2=10.914, P <0.01). The total score of autonomous learning ability was (114.85 ± 6.27) in the intervention group and (90.78 ± 8.22) in the control group, and the difference was statistically significant (t=18.034, P < 0.01). The comprehensive results of nursing students′ practice was (87.04 ± 6.46) in the intervention group and (74.35 ± 6.04) in the control group, and the difference was statistically significant (t=11.115, P< 0.01). Conclusions Clinical teaching rounds based on mini-clinical exercise assessment scale can improve the clinical comprehensive service ability, self-learning ability and humanistic care ability of intern nurses. Key words: Mini clinical exercise; Student nurse; Teaching ward round; Intervention effect

Exploration on application of 3D printed models in the orthopedic clinical internship teaching at basic-level hospital

Objective To evaluate the effect of 3D printed skeletal model in orthopedic clinical in-ternship teaching. Methods From October 2015 to October 2016, 30 undergraduate clinical medical internship students were divided into traditional teaching group and 3D model teaching group randomly. 1 teaching ward round was conducted for each student. Teaching rounds were conducted according to routine procedures in traditional teaching group, while the 3D model teaching group used the patient's 3D print skeletal model to assist in teaching rounds and perform simulated surgery. All students were tested in theory and practice, and the teaching evaluation was carried out by questionnaire. Data were imputed into SPSS 19.0 for comparison between the two groups using t-test. Results Students in 3D model teaching group significantly outperformed than those in traditional teaching group in theoretical achievement [(92.27±4.56) vs. (86.87±5.30)] and practical achievement [(90.07±4.61) vs. (82.53±5.03)] (P<0.01). In respects of pro-moting theoretical knowledge, enhancing surgical participation, hands-on ability exercise, teaching attraction and overall satisfaction, students in 3D model teaching group gave a better evaluation of teaching they had received than those in the traditional teaching group (P<0.01). Conclusion 3D printed skeletal model is an effective teaching tool, and its application in clinical internship teaching at basic-level hospital can signifi-cantly improve teaching effectiveness and satisfaction. It is worth further exploration and promotion. Key words: 3D printed models; Basic-level hospital; Orthopedics; Clinical internship teaching

Balancing health care education and patient care in the UK workplace: a realist synthesis.

Patient care activity has recently increased without a proportionate rise in workforce numbers, impacting negatively on health care workplace learning. Health care professionals are prepared in part by spending time in clinical practice, and for medical staff this constitutes a contribution to service. Although stakeholders have identified the balance between health care professional education and patient care as a key priority for medical education research, there have been very few reviews to date on this important topic. We conducted a realist synthesis of the UK literature from 1998 to answer two research questions. (1) What are the key workplace interventions designed to help achieve a balance between health care professional education and patient care delivery? (2) In what ways do interventions enable or inhibit this balance within the health care workplace, for whom and in what contexts? We followed Pawson's five stages of realist review: clarifying scope, searching for evidence, assessment of quality, data extraction and data synthesis. The most common interventions identified for balancing health care professional education and patient care delivery were ward round teaching, protected learning time and continuous professional development. The most common positive outcomes were simultaneous improvements in learning and patient care or improved learning or improved patient care. The most common contexts in which interventions were effective were primary care, postgraduate trainee, nurse and allied health professional contexts. By far the most common mechanisms through which interventions worked were organisational funding, workload management and support. Our novel findings extend existing literature in this emerging area of health care education research. We provide recommendations for the development of educational policy and practice at the individual, interpersonal and organisational levels and call for more research using realist approaches to evaluate the increasing range of complex interventions to help balance health care professional education and patient care delivery.

Comparation of case-based learning and lecture-based learning in nephrology teaching

Objectives To compare the case-based learning(CBL) and lecture-based learning (LBL) in nephrology teaching and provide a theoretical basis for better mode of the of nephrology teaching. Methods 100 undergraduates in our hospital of medical university were selected as the research object, who were randomly divided into experimental group(n=50)and control group(n=50), studengts in experimental group were taught by CBL, while those in control group were taught by LBL. Unified test and satisfaction survey were given after the teaching ward round, SPSS17.0 software was used to statistical analysis of relevant data, measurement data were expressed as mean standard deviation(±s), independent sample t-test was applied for comparison between two groups, chi-square test was used to analysis count data, there was statistically significant difference between the two groups (P<0.05). Results Test result was (81.76±7.75) in experimental group and (61.58±17.74) in control group, the difference was statistically significant (t=6.030, P<0.001), the scores of experimental group were higher than the control group. Satisfaction rate was 96% in experimental group and 22% in control group, the difference was statistically significant (χ2=56.594, P<0.001), the experimental group's satisfaction was higher than the control group. Conclusions CBL is contribute to cultivate the students' clinical thinking ability and to solve practical problems, is worth popularization and application in nephrology teaching. Key words: Teaching; Kindney Diseases

The Doctor of Medicine curriculum review at the School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania: a tracer study report from 2009.

BackgroundThe School of Medicine (SoM) is one among five at Muhimbili University of Health and Allied Sciences (MUHAS). It currently houses eight undergraduate and many post-graduate programmes. The Doctor of Medicine (MD) programme reported herein is the oldest having ten semesters (5 years) followed by a 1 year compulsory rotatory internship at a hospital approved by the Medical Council of Tanganyika (MCT). However, this training was largely knowledge-based and thus the need to shift towards competency-based education (CBE) and full modularization necessitated this study.MethodsA cross-sectional tracer study of MUHAS MD graduates from SoM who completed training between 2006 and 2008 was conducted using quantitative (structured interviewer-administered questionnaires) as well as qualitative methods [In-depth questionnaire (IDI) and Focus group discussions (FGDs)].ResultsA total of 147 MD graduates were traced and interviewed, representing 29 % of the 510 students who graduated from the SoM between 2006 and 2008. Majority (70.1 %, n = 103/147) were males. About 70 % graduated in 2008 and majority (68 %, n = 100/147) were doing internship. Majority (60.5 % n = 89/147) were based in/near Dar es Salaam at district, regional or referral hospitals. With reasonable concordance, most competencies ranked low except on four aspects. Teaching, System-based Practice and Good Practice had the lowest. Seminars/Tutorials, Laboratory Skills/Practicals, Theatre Skills, Outpatients clinics, Family Case Studies, Visits/Excursions and Self Reflection were rated less useful teaching methods compared to Lectures, Teaching Ward Rounds, Elective Studies, Field Work, Presentations, Continuous Assessments Tests, Final Examinations, Short Answers, Clinical/Practical Examinations. ICT and Library facilities were not considered to meet the students learning needs and Clinical Logbooks also ranked low. Teachers were generally ranked less favorably including in professional role-modelling and accessibility outside scheduled teaching sessions.ConclusionsThis tracer study results allowed subsequent curriculum review and the introduction of full modularization and competency-based learning at MUHAS. It is envisioned that these tracer study findings will improve teaching, learning and inform next curriculum review at MUHAS leading to increased output of appropriately trained health professionals to fill the big gap in human resources for health (HRH) in Tanzania. The revised curricula are also being processed through TCU for accreditation as required.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0745-7) contains supplementary material, which is available to authorized users.

Evaluation of the effect of teaching rounds of the multidisciplinary joint radiotherapy department

Objective To explore the effect of the joint teaching rounds of the multidisciplinary radio-therapy. Methods 54 clinical college students of Grade 2013 was selected as the control group, adopting the traditional single teaching ward round model, while 58 clinical college students of Grade 2014 was se-lected as the research group, adopting the multidisciplinary joint radiation operation mode. By contrasting the satisfaction questionnaire, calculating and delineating the target volume error rate and the theory exami-nation results, the effect of teaching ward round was evaluated. Results ①According to the survey, the research group’s satisfaction in teaching methods, stimulating students' enthusiasm for learning, improving their clinical thinking ability and consolidating the knowledge (respectively 91.38%, 86.21%, 82.76%, 93.10%), was higher than that of the control group (75.93%, 68.52%, 62.96%, 77.78%), and the difference was statistically significant (chi square values were 4.95 5.05, 6.25, 5.36; P<0.05). ②The research group’s pass rate in delineation of Gross Target Volume (GTV) and the Clinical Target Volume (CTV) was (82.76%, 86.21%), higher than that of the control group (53.70%, 62.96%), and the difference was statistically signifi-cant (chi square values were 14.36, 9.48; P<0.01). ③Research group’s score in clinical Three Basics and oncology theory achievement was(88.75±5.23) and (82.72±3.69), higher than the control group [(81.88±613), (80.74±3.25) points], and the difference was statistically significant (t=6.40 respectively, 3.01; P< 0.05). Conclusion Radiotherapy department’s multi-disciplinary joint ward round helps to improve the teaching quality. Key words: Multiple disciplines; Joint rounds; Radiotherapy department

Investigating the prevention of hospital-acquired infection through standardized teaching ward rounds in clinical nursing.

This study aimed to explore the effect of standardized teaching ward rounds in clinical nursing on preventing hospital-acquired infection. The experimental group comprised 120 nursing students from our hospital selected between June 2010 and June 2012. The control group consisted of 120 nursing students selected from May 2008 to May 2010. Traditional teaching ward rounds for nursing education were carried out with the control group, while a standardized teaching ward round was carried out with the experimental group. The comprehensive application of nursing abilities and skills, the mastering of situational infection knowledge, and patient satisfaction were compared between the two groups. The applied knowledge of nursing procedures and the pass rate on comprehensive skill tests were significantly higher in the experimental group than in the control group (P < 0.05). The rate of mastery of sterilization and hygiene procedures was also higher in the experimental group than in the control group (P < 0.05). The patient satisfaction rate with infection control procedures in the experimental group time period was 98.09%, which was significantly higher than patient satisfaction in the control group time period (93.05%, P < 0.05). Standardized teaching ward rounds for nursing education expanded the knowledge of the nursing staff in controlling hospital-acquired infection and enhanced the ability of comprehensive application and awareness of infection control procedures.

Challenges of the ward round teaching based on the experiences of medical clinical teachers

Challenges of the ward round teaching based on the experiences of medical clinical teachers

The Usefulness of the Surgical Knowledge and Skills Acquired via the University Curriculum for Doctors’ Medical Practice Several Years After Graduation

Teaching surgery during university curriculum comprises transferring theoretical knowledge traditionally and simultaneously acquiring manual skills, i.e., suturing, stitch removal, limb immobilization, catheterization, and assisting operations. Observations of doctors several years after graduation led to the reflection that teachers' ideas about surgical knowledge and skills that are useful in daily practice frequently fail to meet the facts of the case. The objective of this study was to determine which part of the surgical knowledge and skills taught via the university surgical curriculum proved to be useful in the daily practice of young doctors. A custom-made questionnaire was designed and mailed to 200 randomly chosen doctors who had graduated from the medical faculty at the authors' university 5 to 6 years previously. The questionnaire comprised 9 items concerning the knowledge and skills that proved to be the most useful in participants' daily practice, regardless of their specialty. A total of 64 completed questionnaires were returned (32% of 200 sent) and were the subject of analysis. The most useful knowledge in daily practice was that acquired from general surgery, followed by oncological and vascular surgery. The most useful was knowledge about the rational interpretation of clinical symptoms and signs acquired from examination of the patient, followed by arriving at an accurate diagnosis through logical analysis, and next developing "oncological sensitivity" to diagnosing neoplasms. The most effective teaching model was specialized outpatient clinic rounds, followed by training manual skills on a model and classical ward-round teaching. The most frequently learned (acquired) manual skills were removal of stitches, rectal examination, and examination of the abdomen. Of these skills, the most useful in daily practice appeared to be removal of stitches, catheterization of the urinary bladder, and wound suturing. Learning and practicing manual skills followed by classical ward-round teaching was considered "skill-/competency-oriented teaching" surgery by all respondents. The results of this study show some discrepancy between the knowledge and skills taught during university surgical curriculum and their actual usefulness in the daily practice of graduates. Awareness of this should have an effect on modification of the curriculum and methods for undergraduate surgery teaching.