Live surgical demonstrations: An old, but increasingly controversial practice

Objective: To survey a group of leading academic urologists from North America and abroad about their opinions regarding the educational value, safety, and ethics of live surgical demonstrations. Materials and Methods: An anonymous survey pertaining to live clinical demonstrations was sent to all active members of the American Association of Genitourinary Surgeons (AAGUS). Results: Ninety (50%) members completed the survey. Most respondents had performed at least one live surgical demonstration (93.2% at away institution, 81.5% at home institution). Overall anxiety level as a visiting professor was rated as moderate, high, and very high by 29.8%, 25.0%, and 17.9% of respondents, respectively. Anxiety while performing demonstrations at one's home institution was reported as moderate, high, and very high by 28.2%, 9.9%, and 8.5% of respondents, respectively. Excessive conversation in the operating room was cited as a major distraction by 41.3% of respondents. Concern over the appropriateness of selected cases was reported often (43.9%) and always (13.4%) of the time. Only 28.2% of AAGUS members would let a visiting faculty member operate on them or a family member. Most (70.9%) respondents felt live surgical demonstrations are morally ethical, but only 30.1% stated they should continue indefinitely in their present form. Conclusion: No studies have been published within the urological literature about live operative demonstrations. Results from the present survey support concerns within the cardiothoracic and endoscopy literature about the continued use of live operative demonstrations. A formal review culminating in the development of an explicit policy statement by urologists should be undertaken.