Teaching advanced surgical anatomy with visual representations: comparing perceptual fluency and sense making

Combinations of perceptual fluency and sense-making competencies contribute synergistically to learning gains in undergraduate science, technology, engineering, and math (STEM) education. However, instructional principles depend on the target of instruction, and in many fields, the targets of instruction are quite different from undergraduate STEM education. Professional learning often involves the application of previously acquired conceptual knowledge in a perceptually complex reality. This paper focuses on the field of surgery, specifically the recognition of surgical anatomy, in which the target of instruction is perceptual ability rather than conceptual knowledge. We conducted two experiments in which 42 and 44 surgical trainees participated in perceptual-fluency and sense-making interventions, followed by tests of their ability to recognize surgical anatomy in real operative images. The results showed that perceptual-fluency interventions contributed to gains in perceptual knowledge relating to surgical anatomy, whereas sense-making interventions did not. We discuss our findings in terms of alignment between instructional design and instructional goals, and the application of advances in learning sciences to adult learning of complex skills.