Designing the Next Phase of the Japanese Surgeons as Educators Course: A Nationwide Needs Assessment Survey of Alumni

Technical Summary: Designing the Next Phase of the Japanese Surgeons as Educators Course

Problem Statement
The Japanese Surgeons as Educators (JSaE) course was established as a national faculty development program to transition surgical teaching in Japan from a traditional apprenticeship model to a structured educational framework. While initial evaluations demonstrated that JSaE participation improves self-assessed teaching competencies and educational practices, the authors note that single-course participation may not ensure long-term retention or successful workplace implementation. This is particularly critical in the Japanese context, where surgical training faces persistent challenges including long working hours, facility-based disparities, and limited non-technical skills training. Despite the recognized importance of needs assessment for continuing professional development, there was a lack of data regarding how to design refresher training for surgeons who have already completed a structured national educator-development program. Specifically, no prior study had clarified which topics, delivery formats, and venues JSaE alumni prioritize for continued development.

Methodology
The study employed a nationwide, cross-sectional needs assessment survey targeting alumni of the JSaE program who had completed both the Basic and Advanced courses.

• Population: The target cohort consisted of 147 graduates from the 1st through 5th Advanced JSaE courses (held between May 2023 and February 2025).
• Instrument: An anonymous online questionnaire was distributed via SurveyMonkey to the official JSaE alumni mailing list between April 1 and May 7, 2025.
• Survey Content: The instrument assessed demographic characteristics, interest in a refresher course, motivations for participation, preferred delivery formats (e.g., workshops linked to meetings vs. full re-attendance), preferred venues (specific academic societies), and priority curricular topics.
• Analysis: Data were analyzed descriptively. Categorical variables were summarized as frequencies and percentages. Item-specific denominators were used to account for non-response on specific items, and multiple-response items were calculated based on the number of respondents answering that specific question. No inferential statistical testing was performed, as the study aimed to provide a descriptive basis for curriculum planning.
• Ethics: The study received approval from the Institutional Review Board of Onomichi General Hospital.

Key Results

• Response Rate: 109 of 147 eligible alumni responded, yielding a 74.1% response rate.
• Demographics: The majority of respondents were in their 40s (60.7%) and held the position of Staff Surgeon (66.4%). Gastrointestinal surgery was the most represented specialty (52.4%), followed by Obstetrics and Gynecology (23.8%).
• Demand for Refresher Course: A strong majority (91.6%; 98/107) expressed interest in attending a JSaE refresher course.
• Motivations: The primary motivation was the reinforcement of previously acquired knowledge (91.8%), followed by learning new or updated educational practices (57.7%).
• Preferred Format: The most favored delivery format was a pre-course workshop linked to an academic society meeting (52.6%), followed by a combination of a workshop and re-attendance at the original course (27.8%).
• Preferred Venues: The Japanese Association for Surgical Education (JASE) annual congress was the top choice (78.4%), followed by the Japan Surgical Society (JSS) and the Japanese Society of Gastroenterological Surgery (JSGS).
• Priority Topics: The three most requested curricular topics were:
  1. Assessment of Surgical Performance
  2. Feedback Techniques
  3. Teaching Surgical Skills
     Other frequently selected topics included Needs Assessment, Teaching in the Operating Room, and Strategies to Motivate Educational Faculty.

Key Contributions
This study provides the first empirical data on the specific needs of JSA alumni for longitudinal faculty development. Its primary contribution is the identification of a clear blueprint for a refresher curriculum that aligns with the core JSaE instructional frameworks. The findings demonstrate that alumni do not seek a completely new curriculum but rather a deeper reinforcement of central teaching philosophies, specifically regarding assessment, feedback, and the segmentation of surgical skills. Furthermore, the study establishes a practical implementation model: a society-linked, workshop-based format that leverages existing academic gatherings to overcome barriers of time and resource availability.

Significance and Claims
The authors claim that these findings provide a practical foundation for the next phase of national surgical faculty development in Japan. The study concludes that there is a strong, demonstrated demand for a longitudinal, society-linked refresher course. By prioritizing topics that align with core JSaE frameworks (such as the BID model for operating room teaching and the verbalization of tacit knowledge), the proposed refresher course aims to address the gap between initial training and sustained workplace implementation.

The paper modestly frames its findings as evidence of perceived need among a motivated subset of JSaE alumni, rather than proof of educational effectiveness. The authors explicitly state that the study does not measure objective teaching performance or learner outcomes. Instead, the significance lies in using these needs assessment results to inform the design of a curriculum that is feasible, relevant, and aligned with the preferences of the target population. The authors suggest that such a program could also serve as a mechanism to identify and train future JSaE instructors, thereby strengthening the national surgical educator community. Future work is proposed to evaluate the actual implementation and outcomes of such a refresher course using structured evaluation frameworks.