Observing But Not Yet Doing: What’s The Value?

 

Introduction:

•       Halsted’s model: “see one, do one, teach one” relies on observational learning.

•       Observational learning: acquisition of knowledge or skills through watching others perform a task without direct physical practice.

•       It is unclear if observation alone facilitates meaningful technical skill acquisition in surgical training.

•       Identifying efficient and evidence-based training strategies is essential.

•       Objective of this study was to determine the effectiveness of observational learning in surgical education.

 

Methods:

•        A systematic review was performed and reported according to the PRISMA 2020 guidelines.

•       PubMed (1946-present), Embase via Elsevier (1947-present), Education Source via EBSCO (1880-present), ERIC via EBSCO (1966-present), and Web of Science Core Collection (1945-present) were searched in March 2025.

•       Inclusion criteria: surgery and surgical subspecialities at any level including medical students, residents, fellows, and attendings.

•       Exclusion criteria: professions outside of surgery and non-English texts.

 

Results:

•       9/12  papers demonstrated a benefit to observational learning.

•       3/12 papers showed worse performance in the observational group.

 

Conclusion:

•       Observational learning confers a measurable benefit in surgical skill acquisition.

•       Effectiveness of observational learning is related to task complexity, learner level, and instructional design.

•       Additionally, there may be a benefit from observing novice or error-strewn performance, challenging traditional assumption that expert modeling is always        superior.

•       Integration of structured observation into surgical curricula may enhance skill acquisition but further investigation is needed.