A Holistic Approach to Enhance FRCS General Surgery Examination Training Using Adult Learning Model: A Non-Profit Initiative
- 1 Bristol Medical School, University of Bristol, Bristol, UK
- 2 Medway Maritime Hospital, Gillingham, Kent, UK
- 3 Frimley Park Hospital, Portsmouth Road, Camberley, UK
- 4 University Hospitals Plymouth NHS Trust, Plymouth, UK
- 5 Northern Devon Healthcare NHS Trust, Barnstaple, UK
- 6 Yeovil District Hospital NHS Foundation Trust, Yeovil, UK
- 7 Inverclyde Royal Hospital, Greenock, Scotland, UK
- 8 Princes Royal University Hospital, Orpington, UK
- 9 Sherwood Forest Hospitals NHS Foundation Trust, Mansfield, UK
- 10 Augusta University Medical Center, Augusta, GA, USA
- 11 University Hospitals Plymouth NHS Trust, Plymouth, UK
Abstract
Objectives: To evaluate the impact of adult learning and simulation-based learning (SBL) on surgical trainees’ learning experiences and Fellowship of the Royal College of Surgeons (FRCS) Section 2 General Surgery examination pass rate. Methods: This was a cross-sequential study involving 148 surgical candidates (72 UK trainees, 75 non-UK trainees) who had attended our revision course (Phoenix FRCS Course) from June 2017 until 2023. Each course comprised a two-day weekend preparation with dedicated sections for clinical, viva, and academic reading, incorporating SBL as its key learning style. We maintained a prospective database of candidate and course details, examination results, and feedback since the course inception. Results: We found that 97% of candidates passed the FRCS examination after their first attempt. The course was attended once by 89% of candidates, and only 3 of the 148 candidates exhausted all four attempts at the examination. Candidate feedback for the course and its style of learning was positive, with simulation-based table viva sessions and virtual clinical sessions proving the most popular learning sessions (95% and 80% of candidates attending courses run in December 2017, April 2018, and May 2021 rated them “ Excellent ” respectively). Conclusions: The course is centered around shared adult learning and mindfulness tools to encourage candidates to learn from each other and develop confidence and mastery in all domains of surgical practice. These methods have been shown to be effective in achieving high success rates in the Intercollegiate and International FRCS examinations for UK and overseas surgeons.
- JCIE Examination Results. https://www.jcie.org.uk/content/content.aspx?ID=9
- Knowles, M. (1984) The Adult Learner: A Neglected Species. 3rd Edition, Gulf Publishing, Houston. (Andralogy)
- Maran, N. and Glavin, R. (2003). Low-To High-Fidelity Simulation—A continuum of Medical Education? Medical Education, 37, 22-28. https://doi.org/10.1046/j.1365-2923.37.s1.9.x
- Lamé, G. and Simmons, R.K. (2020) From Behavioural Simulation to Computer Models: How Simulation Can Be Used to Improve Healthcare Management and Policy. BMJ Simulation and Technology Enhanced Learning, 6, 95-102. https://doi.org/10.1136/bmjstel-2018-000377
- Aggarwal, R., Mytton, O.T., Derbrew, M., et al. (2010) Training and Simulation for Patient Safety. BMJ Quality & Safety, 19, i34-i43. https://doi.org/10.1136/qshc.2009.038562
- Issenberg, S.B., Gordon, M.S., Gordon, D.L., Safford, R.E. and Hart, I.R. (2001) Simulation and New Learning Technologies. Medical Teacher, 23, 16-23. https://doi.org/10.1080/01421590020007324
- Sarker, S.K. and Patel, B. (2007) Simulation and Surgical Training. International Journal of Clinical Practice, 61, 2120-2125. https://doi.org/10.1111/j.1742-1241.2007.01435.x
- The Adult Learning Theory—Andragogy—of Malcolm Knowles. https://elearningindustry.com/the-adult-learning-theory-andragogy-of-malcolm-knowles
- Tutticci, N., et al. (2016) High-Fidelity Simulation: Descriptive Analysis of Student Learning Styles. Clinical Simulation in Nursing, 12, 511-521. https://doi.org/10.1016/j.ecns.2016.07.008
- Weinstein, Y., Madan, C.R. and Sumeracki, M.A. (2018) Teaching the Science of Learning. Cognitive Research, 3, Article No. 2. https://doi.org/10.1186/s41235-017-0087-y
- The Most Mentally Tough People Apply the 1% ‘Marginal Gains’ Rule, says Performance Expert—Here’s How It Works. CNBC Make It. https://tinyurl.com/mr38d9cs
- Polyvagal Theory in Practice. Counseling Today. https://ct.counseling.org/2016/06/polyvagal-theory-practice/
- Bergland, C. (2013) The Neurobiology of Grace under Pressure: 8 Habits That Stimulate your Vagus Nerve and Keep you Calm, Cool, and Collected. Psychology Today.
- Dunkin, B., Adrales, G.L., Apelgren, K. and Mellinger, J.D. (2007) Surgical Simulation: A Current Review. Surgical Endoscopy, 21, 357-366. https://doi.org/10.1007/s00464-006-9072-0