Transforming the Culture of Surgical Education Promoting Teacher Identity Through Human Factors Training

Context: Promoting a culture of teaching may encourage students to choose a surgical career. Teaching in a human factors (HF) curriculum, the nontechnical skills of surgery, is associated with surgeons' stronger identity as teachers and with clinical students' improved perception of surgery and satisfaction with the clerkship experience. Objective: To describe the effects of an HF curriculum on teaching culture in surgery. Design, Setting, Participants, and Intervention: Surgeons and educators developed an HF curriculum including communication, teamwork, and work-life balance. Main Outcome Measures: Teacher identity, student interest in a surgical career, student perception of the HF curriculum, and teaching awards. Results: Ninety-two of 123 faculty and residents in a single program (75% of total) completed a survey on teacher identity. Fifteen of the participants were teachers of HF. Teachers of HF scored higher than control participants on the total score for teacher identity (P < .001) and for subcategories of global teacher identity (P=.001), intrinsic satisfaction (P=.001), skills and knowledge (P=.006), belonging to a group of teachers (P < .001), feeling a responsibility to teach (P=.008), receiving rewards (P=.01), and HF (P=.02). Third-year clerks indicated that they were more likely to select surgery as their career after the clerkship and rated the curriculum higher when it was taught by surgeons than when taught by educators. Of the teaching awards presented to surgeons during HF years, 100% of those awarded to attending physicians and 80% of those awarded to residents went to teachers of HF. Conclusion: Curricular focus on HF can strengthen teacher identity, improve teacher evaluations, and promote surgery as a career choice.