CHANGING SURGICAL EDUCATION STRATEGIES IN AN ENVIRONMENT OF CHANGING HEALTH-CARE-DELIVERY SYSTEMS

Emerging changes in health care delivery will have a significant impac t on the structure of surgical education in academic departments of su rgery. Based on some assumptions as to the probable nature of the fina l product of this reform, this article encourages a proactive stance b y surgical educators to anticipate changes and move toward restructuri ng in areas of curricular content, the teaching process, performance e valuation strategies, and faculty infrastructure of the academic depar tment. Curriculum changes must bridge the gap between public health an d medicine and continue the aggressive trend toward teaching in the ou tpatient setting. Surgical educators must adapt to evolving computer a nd instructional technology that will make multimedia presentations, d istance education, teleconferencing, hypermedia, and virtual reality c ommonplace in the teaching setting. Increased emphasis on accountabili ty and accreditation will require stringent criteria in performance an d program evaluation methodology. The academic infrastructure will nee d to adapt to the changing goal of training more general surgeons and fewer specialists and yet maintain the fundamental responsibility of a n academic surgeon for mentoring the medical student and surgical resi dent.