Like any other discipline, the development of medicine and surgery has depended on effective transmission of knowledge acquired over generations, which in turn has supported new studies that have expanded the scientific evidence available. As surgeons, it is our responsibility to transmit our knowledge to medical students and surgical residents. Furthermore, in order to contribute to the continuous development of our specialty, we must also report the advances and discoveries obtained in our research to the scientific community.
The transmission of knowledge is a communication process involving several components1: sender, receiver, channel (the means of communication) and message (the content of the information). Additionally, a distinction can be made between explicit knowledge, which can be easily documented, structured and transmitted, versus tacit knowledge,2 which refers to the skills acquired through experience and is more difficult to formalize and transmit, although essential in the surgical field.
For effective transmission of information, the sender must adapt the message to the receiver and the channel. It is crucial to avoid the information overload that we tend to experience when mastering a certain area of knowledge, presenting the content in a clear and concise manner, breaking it down into blocks of information, repeating key ideas to facilitate understanding, and adapting the complexity of the information presented to the recipient.
In recent decades, the means of transmitting information has evolved significantly. Classic sources of information, like books and scientific articles, allow for knowledge to be acquired autonomously, with no need for the sender and receiver to coincide in time or space. However, the efficiency of learning improves when the receiver is not merely a passive agent but is instead an active participant.3 The sender must promote active teaching through discussion, reciprocal communication and guided reasoning, encouraging the formulation of questions and answering them. While in-person classes and surgical training remain essential, technology and the multiple digital platforms available have diversified the communication channel and expanded the possibilities for learning. Through webinars, virtual conferences and digital platforms with specific audiovisual content (like AEC Connect), knowledge now reaches a wider and more heterogeneous audience, overcoming geographical barriers and offering valid alternatives in critical situations, such as during the COVID-19 pandemic.
Surgery is based on the practical application of theoretical concepts and the mastery of surgical procedures. The transmission of this tacit knowledge has traditionally been based on the “see one, do one, teach one” method proposed by William Halsted at the end of the 19th century.4 Today, this has evolved into something more similar to “see many, simulate many, do many, teach many”, complemented by both physical and virtual simulation, which provides a safe environment to acquire technical skills before applying them to real patients.5–7
In this process of acquiring knowledge and skills, the standardization of surgical procedures is a key element. By breaking down the process into different phases, both teaching and learning are made easier, and the process can be better internalized. The initial stage entails understanding the phases of surgery through theoretical study, watching videos, and attending live surgeries performed by experts. Afterwards, the knowledge acquired during the observation phase should be put into practice, and procedures are performed under the supervision of an expert to correct any errors. Technological advances have also revolutionized this phase of the training process in terms of the communication channel. Today, telemedicine facilitates live mentoring of surgical procedures by experts who may be thousands of kilometers away, and artificial intelligence can provide objective supervision and feedback during the process of learning surgical skills and decision-making.8
We must bear in mind that tacit knowledge does not only include technical skills. It is necessary to learn how to manage stress, research, make decisions under pressure, work as team, interact with patients and their families, resolve conflicts, etc. These skills must also be transmitted and are required for achieving professional excellence, together with theoretical knowledge and technical skills. Without a doubt, training programs in non-technical skills should be included in our formal training as surgeons,9 as they also affect the health of our patients.10
The effective transmission of knowledge is essential for the advancement of surgery. It requires understanding and optimizing the components of communication. In our role as transmitters, this means diversifying communication channels, adapting the message to the receiver, and promoting 2-way interaction. The ability to transmit what has been learned is not only a desirable skill, but it is our responsibility as surgeons due to its positive effect on the quality of patient care and the future of our specialty. Thus, we should develop and enhance effective transmission of knowledge throughout our careers.
Declaration of Generative AI and AI-assisted technologies in the writing processIn the process of composing this paper, the authors used ChatGPT to adjust the word count to the maximum allowed. After using this tool, the authors reviewed and edited the content as necessary, assuming full responsibility for the content of the publication.
FundingThis research paper has received no specific support from public, commercial or non-profit entities.
