The evolution of surgical education

摘要

Surgery is constantly evolving along the history. Surgery has seen an impressive evolution due to advances in anesthesia, basic research, means of exploration, immunology, genetics, pharmacology and especially in artificial intelligence. Surgery has evolved from open surgery to minimally invasive surgery, then to robotic surgery and in future to digital surgery. The five pillars of digital surgery are: (1) robotics, (2) advanced instrumentation, (3) enhanced visualization, (4) connectivity, and (5) data analytics and machine learning. Surgical education has evolved from Halsted's model (one see, one do, one teach) to special training programs such as the Rasmussen model in 3 stages: skill based behavior, ruled based behavior, knowledge based behavior. Digital technologies are changing surgical education. New terms appear such as: Massive open online courses, Flipped classrooms, Digital badges, Virtual anatomy, Medical holograms. Artificial intelligence can improve surgical education. It can bring transparency to the operating room and accelerate surgical education. Digital Mentoring provides the next generation of the digital platform with the transfer of surgical knowledge from an expert to a practitioner and allows surgeons to evolve to achieve the best results. In addition, all members of the operative team can benefit from training using augmented virtual reality. Establishing an infrastructure that allows the perfect integration of robotics, artificial intelligence, advanced instrumentation, advanced training methods, educational programs will allow the rapid development of innovation and surgical progress. In this way, digital surgery will provide globally advanced surgical care in continuous improvement. The classical methods still remain valid in the training of young surgeons. The most important aspect remains the training in the operating room. The new methods do not exclude the classic training that gave good results, but they complement and make general surgery more attractive for the new generation. In the desire to reform surgical education we have actually lost the purpose of training - the surgical patient, which is real, not virtual. The most important aspect that must be transmitted to young surgeons is the humanism of our profession, which for the time being cannot take the digital form.