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

• A team-based simulation that incorporates senior learners instructing junior learners can be successfully designed and implemented.
• Within this simulation, independent learning objectives can be established for junior and senior learners.
• Although the junior learners focus on technical skill acquisition, senior learners can focus on teaching, team leadership, and operative flow.
• This model of dual learner simulation may illustrate future opportunities for operative simulation.

BackgroundChanging 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).MethodsWe 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.ResultsJL 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.”ConclusionsA 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.