Oppimisen ohjaus kirurgikoulutuksessa

Abstract

The need to develop traditional learning and guidance methods in medical and surgical training has been recognized both nationally (Vilppu et al., 2019) and internationally (Sandhu, 2018). Since the Middle Ages, the professional skills of surgeons have been learned and guided while on the job, using real patients, in a version of the master-apprentice model (Franzese & Stringer, 2007; Gowlland, 2014). In this study, specialist surgical training, conducted within continuing vocational training, in collaboration with a work organization and training organization, was understood as an individual and communal process at work. The training was viewed from the perspective of social, cognitive, cultural, and experiential learning, involving trial and error. This research focused on the basic training phase for doctors specializing in surgery, designated as surgical training. The study aimed to identify the guiding practices in surgical education and the challenges faced, so that guidance for learning could be developed. The study consisted of three sub-studies: The first explored guidance for learning in surgery training. The second analyzed and evaluated learning guidance, especially from the perspective of risk and error in authentic surgery. The third sub-study dealt with the development and testing of a simulation-based training program for practicing basic surgical skills. The study identified six guiding practices related to surgical training: emotional support, succeeding at work, working together, recognizing risks, learning basic skills, and assessing skills. The findings underline many managerial challenges associated with surgical training. Learning guidance should be made more focused and systematic, so that the risks and potential errors involved in the work become part of the learning guidance. Surgical training requires more non-authentic counseling situations, and competence assessment via reflective methods. The simulation-based training program created and tested in this study proved to be effective and motivating for learning.