Surgical Videos: Teaching While Doing
I recently was invited to Lisbon, Portugal as a speaker for the 2018 meeting of the International Sexual Medicine Society (ISSM). The meeting was actually a joint meeting of the ISSM and the European Society of Sexual Medicine (ESSM), and was attended by over 2000 urologists, nurses, sex therapists, and representatives from the surgical device and pharmacologic industries. I lectured on treatment of urinary incontinence after surgery for prostate cancer and how this problem can affect a man’s sex life. I was also asked to present a video of my surgical procedure to treat erectile dysfunction and urinary incontinence under the same anesthetic (at the same time) and instruct meeting attendees as to my technique. This portion of the meeting was a great success and was delivered to a packed auditorium; I was allotted 40 minutes for this but the input and questions from the audience was such that I was on-stage for nearly an hour. I guess I did ok!
Surgery is best taught by a combination of verbal instruction and technique demonstration…. you have to show people what to do in the operating room, but an expert teacher also explains to them why they are doing certain things. For instance, when I demonstrate my technique to place a male sling (to treat urinary leakage) I have to take the time to instruct why I make the surgical moves I am showing and why these intricate actions work together to achieve success; in this case, a dry patient who no longer has to wear pads or diapers. Too often I have seen “experts” operate and try to impress with their speed; they are so concerned about looking fast that they do not actually instruct learners. Worse, they cut corners during the operation leading to complications. The outcome: sloppy surgery, unhappy patients, and frustrated learners. When surgeons from around the world come to me for instruction my priorities line up like this:
#1. Take care of my patient and give him the best possible surgical result.
#2. Take care of the learners in my operating room by ensuring they can see the steps of the operation, AND explain the “why” of these steps.
#3. Try to impress the learners.
If I attain #1, the next two fall into place.
The use of high quality video of my surgery is perfect for a meeting like the ISSM because I can instruct a large number of people at one time, and I can stop the video as needed to explain what I am doing and why I’m doing it. My commentary that I deliver as the videos play, together with the images, bring the operating room into the lecture hall. Sometimes you have to bring the mountain to Mohammed, as the saying goes!! Many of my surgical videos can be accessed through this website; click on the YouTube tab. Take a look and see what my learners see.
Only the true leaders and teachers in sexual medicine and sexual health are invited to lecture and operate at these types of international meetings. I am always grateful when I am asked, and I always try to deliver an educational experience for meeting attendees. Teaching by doing has been the pathway for surgical education for hundreds of years, and that will not change. I am happy to do my part to educate the next generation of experts.