Medical Students Lacking Basic Dexterity

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U.K. surgeon Roger Kneebone says the students he teaches each year don't have the same dexterity as their predecessors.

Young people’s lack of experience of crafts such as sewing mean that young medical students lack the foundation for the practical skills they require for surgery, warns Roger Kneebone, professor of surgical education at Imperial College, London.

“Whereas in the past you could make the assumption that students would leave school able to do certain practical things – cutting things out, making things – that is no longer the case. We have students who have very high exam grades, but lack tactile general knowledge so they struggle even to perform chemistry experiments,” he says.

“An obvious example is of a surgeon needing some dexterity and skill in sewing or stitching. It can be traced back to the sweeping out of creative subjects from the curriculum; it is important and an increasingly urgent issue.”
 
"It seems we can no longer rely on people having developed these ways of using their hands from early childhood, at home and at school," Dr. Roger Kneebone has said.
 

The professor of surgical education at London's Imperial College said colleagues in various branches of medicine have made the same observation.

 

"We're seeing increasing numbers of people who no longer have that sort of basic language using their hands, in the way that — only five or ten years ago — people used to," he said.

 

In secondary schools in the U.K., many of the activities that taught people how to be skilled with their hands — woodwork, cooking, painting, performance art — are now optional in the central curriculum, Kneebone explained.

 

Dr. Kneebone says his medical students are not comfortable cutting or tying string because they don't have the practical experience using these skills. The result is that basic skills like cutting and tying knots are not intuitive for most of Kneebone's medical students — yet it's an integral part of performing surgery.

 
It's not just dexterity, these skills inform an understanding of the world around us through the sense of touch.
 
In surgery for instance, he explained that surgeons always have to make judgments on the state of an organ or tissue, including whether they can be joined together or cut apart.
 

"It's not something that you learn once and apply it in the same way ever after —  you're constantly having to make these judgments in the moment."

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