This article addresses 2 important issues in surgical education: (1) how we design educational curricula and (2) how we assess validity of educational assessments. In the past, many training programs purchased simulators without clear educational goals or objectives. In research terms, this is equivalent to starting a research program without a hypothesis or study methodology, a situation guaranteed to lead to poor results. More recently, surgical educators have begun to (rightfully) focus on educational curricula rather than on simulators. Curriculum design for technical skill education involves setting goals and objectives at the start, designing interventions targeted to those goals, and developing assessment tools that can certify competency in the desired skills. Depending on the goals, curricula may or may not involve the use of simulators. The authors of this article call this process a backward design, because they start with the end goal (a well-trained surgeon) and work backward to develop curricula to meet that goal. Rather than being backward, this could more properly be considered forward thinking.
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