2 During the past 50 years, the original pyramidal structure of the surgical residency has evolved into the rectangular, 5-year programs that are standard today. Dr Halsted's program of apprenticeship, with graded responsibility and emphasis on laboratory investigation, has formed the basis of most American surgical training programs. The original Halstedian approach to surgical training sought to produce surgeon clinicians, researchers, and teachers (3 domains often identified as core values of the modern academic health center). Combined with the surgical training system instituted by Dr William Halsted of The Johns Hopkins University School of Medicine in the 1890s, these advances laid the groundwork for the future of surgical science and training at the turn of the century. 2 The effects of ether anesthesia and aseptic techniques on surgical practice radically increased the number of operations performed during the latter half of the 19th century. Advanced surgical training was often obtained in Europe in the mid 19th century. Prior to the 20th century, medical education in the United States was erratic, lacking in standardization, and poorly regulated. Surgical education and training as a subset of graduate medical education has drawn increasing interest in recent years. The purpose of this article is to explore the concepts of surgical education, simulation, and VR and to determine how and to what extent they overlap and affect the way we train and learn as surgeons. 1 The advent, growth, and development of virtual reality (VR) and simulation as adjunctive educational, training, and certification modalities in surgery will likely affect current surgical practice in ways that may be difficult to predict. The operating room is becoming an increasingly complex environment as technology affects the ways in which surgery is practiced, with marked change during the last 10 years and little to suggest otherwise for the future. The increasing importance of the Internet is but one example of the effect of technology on our lives.Īdvances in instrumentation, visualization, and monitoring have enabled continual growth in minimally invasive techniques in surgery, radiology, and cardiology, among others. One clear example of this change process is the Internet, which provides interactive and instantaneous access to information that was scarcely conceivable only a few years ago. Rapid change in most segments of society is occurring as a result of increasingly more sophisticated, affordable, and ubiquitous computing power. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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