Ethical challenges of in-the-field training: a surgical perspective

The teaching of professions in which technical and manual acts combined with excellent judgment are used to enhance the safety of people, poses challenges to educators. Book learning combined with mock or simulated situations goes a long way, but ultimately “in-the-field” instruction and learning is necessary to qualify trainees for many occupations such as doctors, pilots, firefighters, police officers, and many others. The dilemma is how to teach potentially life-altering techniques in a real-life setting without compromising the safety of the recipient of the service being taught. Using the exemplary model of surgical teaching in the technology-heavy and high-tension world of neurosurgery, the authors attempt to explore this ethical and practical dilemma.