The program in question is the Japanese Surgeons as Educators course, known as JSaE, which was established as a national faculty development initiative to promote structured surgical teaching across Japan. The course runs in two stages, a Basic course followed by an Advanced course, and it has already demonstrated positive educational outcomes in earlier evaluations. Its architects, however, recognized a gap that has been documented across medical education research: even well-designed faculty development initiatives require reinforcement if participants are to retain what they learned and, crucially, implement it in the daily environment of a busy hospital. A systematic review of faculty development initiatives designed to enhance teaching effectiveness, updated as BEME Guide 40, has underscored that one-off workshops rarely produce durable change without follow-up. The JSaE team set out to discover precisely what kind of follow-up their alumni would actually use.

To do this, the researchers conducted a nationwide, cross-sectional survey of JSaE alumni who had completed both the Basic and Advanced courses between May 2023 and February 2025. They distributed an anonymous online questionnaire through the official JSaE alumni mailing list, using the SurveyMonkey platform. The instrument was deliberately practical: it asked about interest in a refresher course, the motivations behind that interest, preferred delivery formats and venues, and the curricular topics that alumni considered highest priority. Responses were analyzed descriptively using item-specific denominators, a methodological choice that keeps each percentage tied honestly to the number of people who actually answered that particular question rather than inflating precision with assumptions about missing data.

The response rate alone makes the findings noteworthy. Of 147 eligible alumni, 109 responded, yielding a 74 percent response rate, a figure that many survey-based studies in medical education would envy. Most respondents were staff surgeons, and gastrointestinal surgery emerged as the most represented specialty, which reflects the demographic weight of that field within Japanese surgical departments. The headline number, though, was the level of demand: 98 of 107 respondents to that item, or 92 percent, expressed interest in attending a refresher course. For a program still in its early phase of national rollout, that is an emphatic endorsement from the very people who have already invested time in completing both course levels.

Why would surgeons who have already finished an intensive two-stage program want to return for more? The survey ranked the motivations, and the leading one was reinforcement of previously acquired knowledge. This aligns closely with what learning science would predict. Ericsson’s work on deliberate practice has argued that the acquisition and, just as importantly, the maintenance of expert performance in medicine requires ongoing, structured engagement rather than a single exposure. Cognitive load theory, developed by Sweller, adds another layer of explanation: complex teaching frameworks, such as models for briefing, intraoperative teaching, and debriefing in the operating room, impose significant mental demands, and without periodic rehearsal the cognitive structures supporting them weaken. The second-ranked motivation, learning updated educational practices, reflects a recognition that the field itself moves. Assessment tools, feedback techniques, and simulation-based methods evolve, and surgeons who teach want to stay current.

The preferences for format and venue reveal a shrewd understanding of how working clinicians actually budget their time. The most popular delivery format was a pre-course workshop linked to an academic society meeting, rather than a standalone event requiring separate travel. When asked where such a refresher should be held, respondents pointed to the annual congress of the Japanese Association for Surgical Education, followed by the Japan Surgical Society and the Japanese Society of Gastroenterological Surgery. This society-linked model solves two problems at once. It reduces the logistical burden of attending yet another meeting in an already crowded professional calendar, and it embeds faculty development within the communities of practice where surgical educators already exchange ideas. Previous needs assessment work by the same research group, both within Japan and across six global regions, has highlighted that surgical trainees and educators face persistent barriers of time and access, making integration into existing gatherings a rational design choice.

On content, the alumni were equally decisive. The highest-priority topics were Assessment of Surgical Performance, Feedback Techniques, and Teaching Surgical Skills. Notably, these priorities align with the core JSaE frameworks already taught in the Basic and Advanced courses, which suggests that alumni are not asking for a fundamentally new curriculum but for deeper, refreshed engagement with the same foundations. The emphasis on assessment echoes findings from the United States, where a study in the American Journal of Surgery defined a pressing need for faculty development specifically in assessment, noting that surgeons are often asked to judge trainee performance without formal training in how to do so reliably. Feedback techniques rank similarly high internationally, since giving effective feedback is among the most consequential and most poorly supported tasks in surgical training.

The broader context in Japan makes this work more than an internal program evaluation. Recent nationwide questionnaire surveys of graduating surgical trainees have documented the current state of the Japanese surgical training system, including facility-based disparities in satisfaction and working conditions across university hospitals, community hospitals, and hybrid-type facilities. Against that backdrop, the quality of teaching that trainees receive is a national concern, not a local one. The establishment of the Japanese Association for Surgical Education itself grew out of an effort to promote systematic surgical education in the country, and the JSaE course represents one of its most concrete instruments. A scoping review of surgical curriculum renewal processes published in Perspectives on Medical Education in 2025 emphasized that successful curriculum change depends on structured needs assessment before redesign, which is exactly the methodological step this survey provides for the program’s next phase.

The study’s authors, led by Akihiko Oshita of Onomichi General Hospital with collaborators spanning institutions from Hokkaido University in Sapporo to the University of Iowa in the United States, conclude that JSaE alumni demonstrated strong demand for a longitudinal, society-linked refresher course. They describe the alignment between the priority topics and the existing core frameworks as a practical foundation for the next phase of national surgical faculty development in Japan. The phrase longitudinal deserves emphasis: the design being contemplated is not another isolated workshop but a continuing relationship between the program and its graduates, delivered at intervals and anchored to the annual meetings where Japanese surgical education already convenes. That model mirrors the Kirkpatrick framework for evaluating training programs, which treats lasting behavioral change in the workplace, rather than immediate satisfaction, as the meaningful endpoint of any educational intervention.

For the international readership of surgical education, the survey offers a template as much as a finding. Needs assessments in continuing professional development have been the subject of their own scoping review, which noted that learning needs assessments are most valuable when they directly shape program design rather than serving as ritual data collection. Here the connection is explicit: 92 percent demand, a named preferred format, three named host societies, and three ranked topics constitute an actionable specification. If the JSaE refresher course proceeds on these terms, Japan will be testing whether society-embedded, reinforcement-based faculty development can close the implementation gap that has long separated what surgeons learn about teaching from what they actually do in the operating room. The results of that experiment will be watched well beyond Japan’s borders, because every country with a surgical workforce struggles with the same quiet problem: teachers trained once, then left to improvise.

Subject of Research: A nationwide needs assessment survey of Japanese surgical faculty development alumni to inform the design of a refresher course for the Surgeons as Educators program

Article Title: Designing the next phase of the Japanese surgeons as educators course: a nationwide needs assessment survey of alumni

Article References: Oshita, A., Poudel, S., Suzuki, A., Imai, K., Takami, H., Kimura, T., Shikama, A., Homma, T., Hida, K., Isobe, M., & Hoshi, H. (2026). Designing the next phase of the Japanese surgeons as educators course: a nationwide needs assessment survey of alumni. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 189. https://doi.org/10.1007/s44186-026-00597-1

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00597-1

Keywords: surgical education, faculty development, Japan, needs assessment, refresher course, surgeons as educators, continuing professional development, assessment of surgical performance, feedback techniques, teaching surgical skills, academic societies, survey research