Elevating Surgical Education: Pilot Year Implementation and Evaluation of the Association for Surgical Education’s ASCENT Curriculum

In the operating room, precision is everything. A surgeon's hands must be steady, their decisions swift, and their technique flawless. For decades, the primary way to learn these skills was to watch a master surgeon and then practice on the patient, a high-stakes apprenticeship where mistakes could have tragic consequences. Today, that landscape has shifted. Medical schools and hospitals now use simulation centers—safe, controlled environments where learners can practice complex procedures on realistic models or computerized patients without risk. These centers allow surgeons to repeat a difficult maneuver until it becomes muscle memory, reducing operating times and improving patient safety. However, a new problem has emerged. While the technology to simulate surgery is widespread, the people who run these centers often lack formal training in how to teach. They are skilled surgeons or technicians with a passion for education, but they have never been taught how to design a curriculum, evaluate a student's performance, or structure a lesson that actually works.

To address this gap, a group of educators from the Association for Surgical Education created a new national program called ASCENT. This initiative was designed to be a standardized training course for the people who teach in simulation centers, specifically targeting surgical residents, early-career faculty, and those in specialized fellowships. Before this program, there was no single, agreed-upon way to train these educators; every institution had its own approach, leading to inconsistent quality. The ASCENT team built a curriculum based on a well-known framework for educational design, breaking down the complex task of teaching into manageable steps. They delivered this training virtually over an eleven-month period, bringing together experts from across the country to teach a diverse group of learners. The goal was not just to share information, but to see if a structured, national curriculum could genuinely improve the confidence and skills of the next generation of surgical educators.

The program unfolded as a series of seventeen virtual sessions, each lasting one hour. The format was simple but deliberate: forty minutes of instruction followed by twenty minutes of discussion. The instructors, drawn from a wide range of medical institutions, covered a broad spectrum of topics, from how to design a course to how to give feedback to a struggling student. They taught the learners how to use different types of simulation tools, how to measure whether a student has actually learned something, and how to integrate new technology into the classroom. The sessions were open to anyone interested, but the organizers capped the number of participants at fifty to ensure that everyone could have a voice during the discussions. Over the course of the year, from September 2023 to August 2024, the program attracted fifty registrants, with an average of sixteen people attending each session.

When the researchers looked at the results, they found that the training worked. After each session, participants were asked to rate their own skills. At the start of the program, many learners felt they were not very proficient in areas like curriculum design or research. By the end of a single session, their self-rated confidence had shifted noticeably upward. For example, in a session about applying educational theories to leadership, the average rating of proficiency improved significantly, with far fewer people feeling unprepared and many more feeling capable. This pattern held true across the entire year. The learners reported that they felt more confident in their ability to design a course, evaluate a student, and conduct research. They felt they had gained practical tools they could take back to their own hospitals and use immediately.

To get a deeper understanding of the experience, the researchers asked the participants to fill out a detailed survey at the very end of the program. Seventeen people, representing about a third of the original group, completed this final evaluation. The feedback was overwhelmingly positive. The learners praised the program for its breadth and the high quality of the instructors. They felt the content was relevant to their careers and that the learning environment was respectful and supportive. The highest-rated aspect was the sense that they were treated with dignity throughout the program. However, the survey also revealed where the program could improve. While the technical skills were strong, the participants felt the program was less successful at building a sense of community or providing deep mentorship. They noted that the virtual format, while accessible, sometimes made it hard to feel truly connected to one another.

The researchers also listened closely to what the participants said in their written comments. A clear theme emerged: the learners wanted more interaction. They enjoyed the lectures but found the webinar style challenging for deep engagement. They suggested that future sessions should include more breakout groups, real-time projects, and hands-on activities where they could practice what they were learning. They also pointed out that the scheduling was inconsistent, which made it difficult for people with busy clinical schedules to attend every session. Some participants felt that the content did not always match their specific level of experience, with some advanced learners finding the material too basic and others finding it too complex. Despite these challenges, the impact on their professional lives was tangible. Many reported that they were already applying what they learned, using new methods for briefing and debriefing students, and planning better educational programs at their institutions.

The study concluded that ASCENT represents a significant step forward in surgical education. It is the first standardized national curriculum designed specifically for surgical simulation educators. The program proved that it is possible to train a diverse group of educators effectively through a virtual format, giving them the confidence and skills to build better simulation programs. The researchers found that the curriculum successfully addressed a critical need in the field, providing a structured path for those who want to lead in surgical education. However, they also acknowledged that the work is not finished. The feedback highlighted that future versions of the program need to focus more on building community, offering more flexible scheduling, and creating more opportunities for active, hands-on learning. The program has been approved for a five-year run, with plans to expand and refine the curriculum based on these initial findings. By continuing to adapt and improve, ASCENT aims to ensure that the next generation of surgical educators is as well-prepared as the surgeons they will one day teach.