The briefing, intraoperative teaching, debriefing model for teaching in the operating room.

r he need for a more deliberate approach to operating room eaching becomes more imperative as duty hour restricions limit the exposure residents have to the operating oom. A good model for deliberate teaching in the operatng room would focus the teacher on setting objectives for he learner’s performance, providing immediate and speific feedback, and providing guidance for future practice. he ideal model would allow surgeons to achieve these ducational goals within the context of their already existng practice. We propose a model for teaching in the operting room that fosters good educational practice, takes dvantage of the naturally existing observation and teachng opportunities available to the teaching surgeon, and fits asily into the surgeon’s existing routine. Surgical residency, as Atul Gawandedescribed it, coninues to depend on “the wonderful, time-honored, throatonstricting method of learning-by-doing on the job trainng . . ..” Reznick and MacRae concurred, stating that olume is the hallmark of surgical training. “Learning by oing” rests on the belief that experience alone will lead to earning. This is a pure discovery model of learning, preised on the idea that through practice and self directed earning, students will develop appropriate rules and unerstandings to guide future practice. Mayer made the onvincing case that pure, unguided discovery learning is neffective and inefficient, does not guarantee that students ill even come in contact with the needed learning opporunities, and does not guarantee that students will learn the ules that guide future practice. He reviewed three lines of esearch in which students were called on to learn, either hrough pure discovery learning or through guided discovry learning. In guided discovery learning, an expert proides the novice with preparatory information before the xperience and offers verbal and perhaps manual guidance uring the experience and feedback afterward. In each case, he students using guided discovery learning learned more uickly, more accurately, and were more likely to remember