Education WISE

Asking the Big Questions

Tiffany Brocke, MD

Before joining the General Surgery Residency at Washington University School of Medicine in St. Louis, it was clear to Tiffany Brocke, MD, that the program trained not only highly skilled surgeons, but also leaders who are constantly asking the “big questions” to improve the field of surgery. Now, as the current ACS-AEI Education Fellow at the Washington University Institute for Surgical Education (WISE), Brocke is able to ask and answer some of those questions.

Brocke grew up in Bay City, Michigan. She studied biochemistry and Latin at the University of Michigan and went to medical school at Johns Hopkins University. She was initially drawn to the General Surgery Residency Program at Washington University because of its reputation and strength in surgical education.

“WashU is always highly ranked and consistently produces graduates who have extraordinary technical skills,” Brocke says. “Which I think is in part because there’s such an emphasis on surgical education in the department.”

One of the main components that makes training within the Department of Surgery exceptional is WISE, which was one of the first surgical skills labs in the country established to serve a general surgery residency program.

In 2018, WISE established an ACS-AEI accredited education fellowship. This fellowship, led by Michael Awad, MD, PhD, director of WISE, is designed to develop future leaders and scholars in surgical education, simulation and training. Residents have the opportunity to spend their lab years focused on simulation and education in a structured academic surgery program.

Brocke was interested in this position because of her background in history and interest in combining different disciplines together to improve the field of surgical education.

“I did a lot of history of medicine research in med school, and I’ve always liked asking the big questions,” she explains. “I like that surgical education draws on a multidisciplinary background – you ask questions using the scientific method and draw on your medical knowledge, but there’s a lot of educational theory, effective communication, and psychology elements to it. It’s a field that draws on all these different domains.”

As an ACS-AEI Education Fellow, Brocke works with both medical students and residents. She acts as a mentor to medical students and aims to make them more comfortable as they start their rotation in the Department of Surgery. She then helps prepare them for the shelf exam at the end of their surgery clerkship.

Brocke also plays a major role in the planning and execution of general surgery residents’ curriculum and skills labs. Currently, she is investigating how simulation training can improve their skills in certain areas.

“Part of my job is to help identify areas that are appropriate for simulation-based training, where if we can come up with the right model in the right scenario and the right teachers, then we might be able to give the residents a skill that would then translate into real patient care,” Brocke says.

There are also some changes coming down the pipeline in surgical education nationally that Brocke hopes to support residents through. The Accreditation Council for Graduate Medical Education (ACGME) plans on changing how they accredit surgeons, using a new competency-based assessment model rather than the traditional time-based model.

“As that gets implemented in the next year or two, I’m hoping to be a voice for the residents and help that transition be executed in a way that continues to prioritize their education,” she says. “If I can put something together and create a project or training that the residents and the medical students find useful, then I’ll be happy with that.”

Brocke has already found this role to be incredibly rewarding. Whether teaching a medical student how to suture or helping an intern during a simulation lab, she finds the one-on-one education very meaningful and enjoys seeing their skills improve.

“I think that’s why a lot of our faculty are so devoted to the residents here, because they get that same kind of reward out of seeing people grow and gain confidence as they master a new skill,” she says.

Washington University has a legacy of faculty who are nationally recognized in surgical education. With the constant innovations, changes and improvements to surgical education programs, Brocke is looking forward to building upon that legacy within the Department of Surgery and beyond.

Dr. Olson, our new chair, has made it very clear that he is going to continue to prioritize the education of new surgeons on an institutional level,” she states. “I think really knowing that the departmental support is there for whatever big questions you want to try to investigate and work on makes a big difference.”