This has been successfully introduced to local and national level in Surgical Student societies and as well as foundation years.  It has even been met with enthusiasm at a school careers fare.

The art of surgery starts with an understanding of the instruments, soft hands, respect of the tissues and coordinated movement.  Deliberately practice requires models that offer feedback: the low fidelity model we use fulfill this need.

The learning needs to be overseen by an expert.  Progression is dependent on mastering the basic steps and understanding the ‘Why’ of what we are doing.  This is realizing the tacit knowledge of the expert surgeon and making it explicit.

Surgeons are very goal orientated and respond accordingly especially if there is a perceived reward.

The acquisition of these skills has been from the format used in martial arts.  The progress and mastery of the basic movement will result in improved flow and accuracy.  The first skill to master is correctness.

The concept of the Black Belt Academy of Surgical Skills is offered.  This addresses many surgical concerns.  The concept of diastolic learning focuses on basic techniques for the early surgeon:

• The tacit is now explicit and can be taught
• The practice is deliberate
• The models are available all the time at home
• It offers a clear syllabus
• It is not a one off

The benefits are clear. The training surgeon has a framework to practice and understand their skills.  There are assessed at regular intervals and progression is documented.  The aspiring surgeon and their trainers, as well as the patient, will see and feel the benefit of honed skills when they eventually get to theatre.

This offers the surgical profession an opportunity to instill enthusiasm and pride in the skills of surgery are very early age.  There is no reason why it should not open to A level and medical students: many surgeons knew the wanted a career in surgery at an early age.  We will able to identify the rising stars.

We can make this fun and a powerful attractor for our profession.  The aspiring surgeon registers their intent to improve their skills and over a minimum of eighteen months attend skills workshops and grades.  The registration and management is set up on a smart phone app.

A registration fee GBP 50/  NZD 75 entitles the trainee to a eighteen months tuition and a basic set of instruments with which high to practice