Factors in optimizing the learning environment for surgical training.

Today's surgeon is required to demonstrate a variety of professional competencies in an increasingly complex environment. Recently, the time available to train this surgeon has started to erode due to external pressures on administrators and faculty. This growing crisis has led to questions about how to optimize learning in the surgical environment. Clearly, to adequately train a competent surgeon in all the required aspects, multiple environments will be required. We must, therefore, look carefully at each environment to maximize its educational potential for each of the competencies. At the same time, however, we must ensure these educational environments and opportunities integrate into a coherent and systematic program of training that is flexible and adaptable to the individual needs of the trainees. This paper describes two broad areas that must be at the forefront of the community's thinking as we strive toward this goal: the irreplaceable value of a mentor and maximizing the potential of optimal challenge points in learning.