After reading Waddell’s Editors’ View in the October 2000 issue of the Canadian Journal of Surgery (page 326), we are still searching for the “controversial” theme, which was extracted from it and translated into a front-page story in The Ottawa Citizen on Tuesday, Nov. 21, 2000, by reporter Ian MacLeod. The front page screamed the headline “Ethics lessons rob surgeons of scalpel skills.”
In the Canadian Journal of Surgery, from which MacLeod is quoting, Waddell argues rightly for the need to learn the skills of surgery “hands on.” In the last paragraph, he points out the competing demands on a resident’s time and advises those in charge of training to lobby the Royal College of Physicians and Surgeons of Canada to stop “increasing demands for didactic teaching in nonclinical areas such as ethics and communication, which are much better learned by direct observation of role models in the clinical setting.”
Wouldn’t it be nice if we lived in a world where ethics and communication skills were modelled by direct observation of role models? Sadly, and based on the facts, we still need to teach it.
Reporter Ian MacLeod has sensationalized the discussion. MacLeod misses the point about “didactic” versus practice-based teaching. Dr. Waddell himself does not disagree with learning ethics and communication skills, he states later in the editorial. He concedes there might be some advantages for a patient if the surgeon has learned communication skills.
What might be argued is the means to that end. Dr. Nadia Mikhael, the director of education for the Royal College, confirms in The Ottawa Citizen article that it is the surgeons themselves who are responsible for training surgical residents and who have identified the importance of teaching communication skills and ethics during surgical training. There is absolutely no argument over the fact that new trainees need to learn ethics and communication skills and that this should occur early in their training. Why would such a headline make the front page a newspaper such as The Ottawa Citizen?