AB172. Educational theory and general surgery: creating a culture of reflective learning in a busy general surgery department

Background: Teaching in general surgery can often be sparse due to busy wards. A culture of education may not exist in many surgical departments, and it can be difficult for juniors to meaningfully and critically engage with the evidence behind daily practice. We established a weekly general surgical teaching programme using educational theory to create a space for critical learning, reflection and the development of clinical educators.

Methods: Our teaching programme encouraged both tutors and learners to critique the evidence. We also used reflective models of learning and advocated the use of social media and technology to improve educational outcomes. We challenged power structures by reversing the traditional surgical hierarchy by encouraging junior doctors to teach both their colleagues and their seniors. Thus we created a common learning space between the most junior and senior members of the surgical team. Lastly, we evaluated our sessions on a weekly basis and reflected upon this for continual development.

Results: Our teaching programme has been highly successful and continues to run to a high standard. Consultants and registrars have been attending to learn from their younger colleagues and social media has allowed learning to continue on the virtual platform. We have established a culture of criticality, reflection and learning in our general surgery department. We struggled initially to change the culture of learning in the department with reticence from both the juniors and the seniors due to workload. We also faced some logistical problems. We discuss how we overcame these barriers.

Conclusions: Establishing educational theory-driven change in general surgery departments is difficult but rewarding. By establishing regular and reflective general surgery teaching every week, we have broken hierarchical barriers and created a culture which enforces evidence-based practice.

Keywords: Educational theory; evidence-based medicine; general surgery; hierarchy; reflection