Introduction
Surgical training in the United Kingdom consists of a well-defined
curriculum set by the Intercollegiate Surgical Curriculum Project (1).
In order to meet the outcome of this curriculum and progress through
different stages in their training, surgical trainees need to
demonstrate competency in specialty-based knowledge, clinical judgement
and operative skills at each benchmark review. Given the time
constraints from the European Working Time Directive and general service
provision within the NHS, educational opportunities are limited and
these opportunities need to be utilized strategically (2). The operating
theatre being the primary learning environment for trainees to acquire
procedural skills, needs to be optimized to ensure effective training
can take place.
The operating theatre as a learning environment is well studied in
current literature (3,4). Common themes of such a conductive learning
environment include relationship-based mentoring, availability of time
and structured teaching (5). Trainees’ positive perception on the
quality of the learning environment is imperative for successful
training (3,6). As such, studies on evaluating the learning environment
in the form of trainee-led feedback questionnaire have been performed in
the past. Notable examples include the Postgraduate Hospital Education
Environment Measure (7) and the Anaesthetic Trainee Theatre Education
Environment Measure (8). An effective feedback instrument will allow
trainers to identify the strengths and weaknesses in the learning
environment, guide future changes, and ensure successful training.
Regarding feedback instrument for the theatre learning environment, the
Cassar questionnaire was developed almost two decades ago and is
orientated towards basic surgical trainees (9). In this study, we built
on the Cassar questionnaire and developed an updated feedback instrument
that reflects the evolvement of surgical training in the past twenty
years and tailored this instrument towards higher surgical trainees.
This instrument was then validated in a three-stage validation process
and is currently utilized in our local specialty training program.