Teaching communication and supporting autonomy with a team-based operative simulator

BACKGROUND: Changing residency structure emphasizes the need for formal instruction on team leadership and intraoperative teaching skills. A high fidelity, multi-learner surgical simulation may offer opportunities for senior learners (SLs) to learn these skills while teaching technical skills to junior learners (JLs). METHODS: We designed and optimized a low-cost inguinal hernia model that paired JLs and SLs as an operative team. This was tested in 3 pilot simulations. Participants' feedback was analyzed using qualitative methods. RESULTS: JL feedback to SLs included the themes "guiding and instructing'' and "allowing autonomy.'' Senior Learner feedback to JLs focused on "mechanics,'' "knowledge,'' and "perspective/ flow.'' Both groups focused on "communication'' and "professionalism.'' CONCLUSIONS: A multi-learner simulation can successfully meet the technical learning needs of JLs and the teaching and communication learning needs of SLs. This model of resident-driven simulation may illustrate future opportunities for operative simulation. (C) 2016 Elsevier Inc. All rights reserved.