1. Training adaptive endoscopic surgeons: the didactical paradox

Surgical training has a longstanding tradition based on the master-apprentice method. Patient safety and quality of care are intrinsically safeguarded through this approach. However, the surgical environment has changed drastically in recent decades, meaning this concept is no longer a valid method of training. It is time for a change. Technological developments, breaking with the long-hours culture, and increasingly limited opportunities for on-the-job training have resulted in a focus on simulation-based training to complement or even replace learning in the workplace. However, many training programs in skills labs adopt the traditional “see one, do one, teach one” approach, potentially limiting the transfer of what is learned to clinical practice. A paradigm shift in the didactical method is needed; a shift in responsibility is required. This chapter describes a different approach to learning in a simulated surgical environment for both trainees and experts.