Surgical education has become increasingly recognized as a fundamental component of training for medical students and residents among surgical faculty in Japan. Educational institutions are now actively establishing structured programs and exploring evidence-based teaching methods to enhance the training of future surgeons. However, central questions remain: How should surgical competency be evaluated? How can rigorous evaluation criteria be defined for residency programs? What teaching methods are most effective?

While research in surgical education began over forty years ago in North America to address these questions and has since matured into a robust academic discipline, in Japan a systematic, research-driven approach to surgical training is still evolving. In this context, our department has played a pioneering role through the establishment of the Surgical Education Research Group, dedicated to advancing surgical education research and practice in Japan.

This vision was championed by our founder, the late Yo Kurashima, MD, PhD (1969–2024). Dr. Kurashima was a visionary surgical educator who recognized early in his career that surgical education in Japan lacked the structured, research-based foundation seen in North America. After completing his medical training at Akita University and his surgical residency at Hokkaido University, he pursued advanced fellowship training at McGill University in Canada, where he immersed himself in evidence-based surgical education and contributed to the development of assessment tools and simulation models that shaped his educational philosophy. Upon returning to Japan in 2012, he established this research group as one of the country’s first dedicated teams focused on surgical education research. Under his leadership, the group produced influential research, secured multiple competitive grants, and contributed to the establishment of surgical education as an academic specialty in Japan. His extensive work with national societies, interdisciplinary collaborations, and frequent lectures throughout the country played a critical role in raising awareness of rigorous, evidence-based educational methods. In 2014, he also played a key role in establishing the Japanese Association for Surgical Education (JASE) (http://www.surgicaleducation.jp), bringing together surgical educators from across Japan. His untimely death in August 2024 in a tragic outdoor accident left a profound void in the surgical education community both in Japan and worldwide.

Our group continues to build on Dr. Kurashima’s legacy by developing innovative surgical education curricula for medical students and postgraduate trainees, organizing educational seminars, and leading national and international collaborative projects. Since 2018, we have also been engaged in global surgical education initiatives, collaborating with institutions and societies in developing countries to share knowledge, expertise, and educational frameworks.

As a leader in Japanese surgical education, we are actively pursuing research that aims to create novel educational tools and systems to further enhance surgical training. We welcome collaboration and invite those interested in our work to contact us.

Current Research Projects

1.Global surgical education

2.General Surgical Training system around the world

3.Analysis of simulation training in abdominal trauma treatment

4.Correlation between evaluation and training of non-technical skills and intraoperative performance in laparoscopic surgery

5.Artificial Intelligence–Based Skill Assessment in Laparoscopic and Robotic Inguinal Hernia Surgery

6.A Nationwide Survey on the Current Status and Challenges of Surgical Education in Japan

7.Learning Curve and Cognitive Load of Junior Surgical Residents in Robotic-Assisted Thoracoscopic (RATS) Lobectomy

8.Impact Assessment of Implementing the Scrub Nurse Performance Evaluation Tool (SCOPE) in the Operating Room

9.Needs Assessment and Curriculum Development for Medical Student Clinical Clerkships Led by Early-Career Breast Surgeons

10.A Questionnaire Survey on Burnout and Turnover Intention among Gastrointestinal Surgeons in Hokkaido

11.A Qualitative Study on the Process from Burnout to Turnover among Gastrointestinal Surgeons

Our published work (Since 2014)

Journal Papers

Published in 2025

1.Ishido K, et al. Human Factors and Team Safety in Robotic-Assisted Surgery: A Narrative Review of Ergonomic Risks and Educational Implications. Journal of Robotic Surgery. 2025 83 (2), 103799

2.Suzuki A, Poudel S, et al. Assessing the impact and effectiveness of the Japanese surgeons as educators program: a faculty development initiative for surgical educators in Japan. Global Surg Educ 5, 9 (2026).

3.Naito Z, et al. Development of Nontechnical Skills Assessment Tool and The Validation Study for Laparoscopic Inguinal Hernia Repair. J Surg Educ. (2026) 83(2)103799.
https://www.sciencedirect.com/science/article/abs/pii/S1931720425003800

4.Ishido K, et al. Burnout as a process driver of surgical attrition: a narrative review of the path to dropout. Global Surg Educ 5, 7 (2026).
https://doi.org/10.1007/s44186-025-00418-x

5.Ishido K, et al. Feasibility of a mutual intraoperative evaluation system for residents and attendings in Japan: a pilot single-center study. Global Surg Educ 4, 83 (2025).
https://doi.org/10.1007/s44186-025-00396-0

6.Ishido K, et al. Developing an objective framework for scrub nurse training: A Japanese pilot study. Developing an objective framework for scrub nurse training: Japan pilot on feedback and skills. Journal of Perioperative Nursing 38(3) (2025).
https://doi.org/10.26550/2209-1092.1384

7.Ishido K, et al. Cultural and Organizational Resistance to Surgical Education Reform: A Narrative Review. J Surg Educ. (2025) 82(9) 103587.
https://doi.org/10.1016/j.jsurg.2025.103587

8.Ishido K, et al. Challenges faced by novice surgeons in preoperative preparation for emergency surgery: a qualitative study. Global Surg Educ 4, 68 (2025).
https://doi.org/10.1007/s44186-025-00379-1

9.Ishido K, et al. Differences in preoperative preparation between young surgeons and experts: A Scoping Review. J Surg Educ. (2025) 82:7
https://doi.org/10.1016/j.jsurg.2025.103540

10.Koike D, Takagi K, Arai K, Kiyasu Y, Kohmura T, Suda C, Takamori S, Takayama W, Nakamura M, Fukumoto M, Yamaoka-Fujikawa Y, Watanabe G, Watanabe J, Poudel S, et al. A nationwide questionnaire survey to investigate facility-based disparities in satisfaction and working conditions of surgical trainees in Japan: university hospitals, community hospitals, and hybrid-type facilities. Surg Today 55, 1701–1709 (2025).
https://doi.org/10.1007/s00595-025-03081-3

11.Murakami M, Poudel S, et al. Successful Introduction of a New Pediatric Endoscopic Procedure in Nepal by Simulation-Based Training Using a Disease-Specific Simulator. World Journal of Surgery. 2025 July 49(7)1862-1869
http://doi.org/10.1002/wjs.12672

12.K Hirose, S Poudel, S Murakami, Y Kurashima, et al. How confident are the general surgeons in Hokkaido region in performing essential trauma skills: a cross-sectional questionnaire survey. World Journal of Emergency Surgery 20 (1), 1-10
https://link.springer.com/article/10.1186/s13017-025-00623-5

13.Murakami S, Shichinohe T, Kurashima Y, et al. Validation of cadaver-based trauma surgery training for lifelong skill development. World J Emerg Surg. 2025 May 29;20(1):45.
https://wjes.biomedcentral.com/articles/10.1186/s13017-025-00608-4

14.Morita R, Kurashima Y, et al. Effect of a Training System Utilizing 3-Dimensionally Printed Patient-Specific Vascular Models on Endovascular Catheterization Performance. J Vasc Interv Radiol. 2025 May;36(5):901-907.e2.
http://sciencedirect.com/science/article/pii/S1051044325000466?via%3Dihub

15.Fukumoto M, Poudel S*, et al. Evaluating the Role and Future Directions of the Japanese Association for Surgical Education: A Needs Assessment Survey among Participants in the Annual Meetings. Global Surg Educ. (2025) 4:35

16.Watanabe G, Watanabe J, Hayashi S, Konishi T, Poudel S, et al. Regional disparity in surgical residency training and work environment between urban and regional hospitals: an additional perspective from a nationwide survey for surgical residents. Surg Today 55, 1143–1154 (2025).
https://doi.org/10.1007/s00595-025-03011-3.

17.Kiriyama K, Kurashima Y, Poudel S*, et al. Enhancing Surgical Skills through Telesimulation: A Multicenter Randomized Controlled Trial on Laparoscopic Inguinal Hernia Repair. Surgery. (2025) 180; 109136
https://doi.org/10.1016/j.surg.2024.109136

18.Poudel S. in memory of Dr. Yo Kurashima (1969–2024). Global Surg Educ 4, 43 (2025).
https://doi.org/10.1007/s44186-025-00353-x

19.Poudel S, Kurashima Y, et al. Needs assessment survey for global surgical education: What do surgical trainees and educators around the world need? Global Surg Educ 4, 18 (2025).
https://doi.org/10.1007/s44186-024-00325-7

Published in 2024

20.Kiyasu Y, Poudel S, et al. "Present Status of the Surgical Training System in Japan: A Nationwide Questionnaire Survey among Graduating Surgical Trainees. Surg Today 55, 90–98 (2025).
https://doi.org/10.1007/s00595-024-02884-0

21.Murakami M, Kurashima Y, et al. “How many cases do young pediatric surgeons need to experience to achieve autonomy in performing pediatric endoscopic surgery? A nationwide survey to establish an ideal curriculum for pediatric endoscopic surgery in Japan. Pediatr Surg Int. 2024 Dec 31;41(1):54.
https://link.springer.com/article/10.1007/s00383-024-05958-9

22.Ebina K, Abe T, Higuchi M, Hotta K, Furumido J, Iwahara N, Senoo T, Komizunai S, Tsujita T, Sase K, Chen X, Kurashima Y, et al. Surgical skill analysis focused on tissue traction in laparoscopic wet lab training. Surg Open Sci. 2024 Aug 22;21:7-13.
https://www.sciencedirect.com/science/article/pii/S258984502400112X?via%3Dihub

23.Yan L, Ebina K, Abe T, Kon M, Higuchi M, Hotta K, Furumido J, Iwahara N, Komizunai S, Tsujita T, Sase K, Chen X, Kurashima Y, et al. Validation and motion analyses of laparoscopic radical nephrectomy with Thiel-embalmed cadavers. Curr Probl Surg. 2024 Oct;61(10):101559.
https://www.sciencedirect.com/science/article/pii/S0011384024001205?via%3Dihub

24.Ebina K, Abe T, Yan L, Hotta K, Shichinohe T, Higuchi M, Iwahara N, Hosaka Y, Harada S, Kikuchi H, Miyata H, Matsumoto R, Osawa T, Kurashima Y, et al. A surgical instrument motion measurement system for skill evaluation in practical laparoscopic surgery training. PLoS One. 2024 Jun 25;19(6):e0305693.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0305693

25.Tojima H, Murakami S, Poudel S, Kurashima Y, et al. Development of a simulator and training curriculum for liver trauma surgery training for general surgeons. Glob Surg Educ.2024;3:36
https://doi.org/10.1007/s44186-024-00233-w

Published in 2023

26.Murakami M, Onishi S, Yamada K, Ogawa K, Yokoyama S, Kurashima Y, et al. How many cases do instructor class pediatric surgeons need to experience to be an independent operator in performing advanced endoscopic surgery? A nationwide survey to establish an ideal curriculum for pediatric endoscopic surgery in Japan. Pediatr Surg Int. 2023 Sep 9;39(1):271. doi: 10.1007/s00383-023-05550-7.
https://link.springer.com/article/10.1007/s00383-023-05550-7

27.Hirose K, Murakami S, Kurashima Y, et al. Delphi Method Consensus-Based Identification of Primary Trauma Care Skills Required for General Surgeons in Japan. J Acute Care Surg. 2023;13:58-65.
https://www.jacs.or.kr/upload/pdf/jacs-2023-13-2-58.pdf

28.Hida K, Hirano S, Poudel S, Kurashima Y, et al. The degree of satisfaction and level of learning in male and female surgical residents: a nationwide questionnaire survey of graduating residents in Japan. Surgery Today. 2023;53:1275-1285
https://doi.org/10.1007/s00595-023-02683-z

29.Mizunuma K, Kurashima Y, Poudel S, et al. Surgical skills assessment of pancreaticojejunostomy using a simulator may predict patient outcomes: A multicenter prospective observational study. Surgery. 2023;173:1374-1380
https://doi.org/10.1016/j.surg.2023.02.027

30.Yokoyama S, Kurashima Y, Ieiri S, et al. Comprehension of fundamental knowledge about pediatric endoscopic surgery: a cross-sectional study in Japan. Surg Endosc. 2023;37:6408-6416
https://doi.org/ 10.1007/s00464-023-09975-y

Published in 2022

31.Kiriyama K, Poudel S, Kurashima Y, et al. Development of a systematic telesimulation curriculum for laparoscopic inguinal hernia repair. Glob Surg Educ. 2022;1:52
https://rdcu.be/cXYYC

32.Kurashima Y, Kitagami H, Teramura K, et al. Validation study of a skill assessment tool for education and outcome prediction of laparoscopic distal gastrectomy. Surg Endosc. 2022;36:8807-8816
https://doi.org/10.1007/s00464-022-09305-8

33.Poudel S, Kurashima Y, Hirano S. Establishing the Japanese Association for Surgical Education: Our experience of promoting systematic surgical education in Japan. Global Surg Educ. 2022;1:16
https://rdcu.be/cLdTE

34.Teramura K, Imai S, Watanabe Y, et al. Development of a performance rubric for transanal endoscopic rectal purse-string sutures. Tech Coloproctol. 2022;26:109-115
https://link.springer.com/article/10.1007/s10151-021-02545-1

Published in 2021

35.Murakami M, Poudel S, Bajracharya J, et al. Support for Introduction of Pediatric Endosurgery in Nepal as Global Pediatric Surgery: Preliminary Needs Assessment Survey. J Laparoendosc Adv Surg Tech A. 2021;31:1357-1362
https://doi.org/10.1089/lap.2021.0307

36.Kondo A, Watanabe Y*, Ishida M, et al. Particle size distributions in surgical smoke generated by advanced energy devices: a meaningful perspective from an experimental study in the time of COVID-19. Ann Surg. 2021;273:e168-e170
https://www.doi.org/10.1097/SLA.0000000000004807

37.Kurashima Y, Hirano S, Yamaguchi S. Can general surgeons perform laparoscopic surgery independently within 10 years of training? A nationwide survey on laparoscopic surgery training in Japan. Surg Today. 2021;51:1328-1334
https://doi.org/10.1007/s00595-020-02218-w

Published in 2020

38.Hashimoto D, Poudel S, Hirano S, Kurashima Y et al. Is there disparity between regions and facilities in surgical resident training in Japan? Insights from a national survey. Surg Today. 2020;50:1585-1593
https://doi.org/10.1007/s00595-020-02037-z

39.Watanabe Y, et al. An Unmodulated Very-Low-Voltage Electrosurgical Technology Creates Predictable and Ultimate Tissue Coagulation: From Experimental Data to Clinical Use. Surg Innov. 2020;27:492-498
https://doi.org/10.1177/1553350620904610

40.Poudel S, et al. Are graduating residents sufficiently competent? Results of a national gap analysis survey of program directors and graduating residents in Japan. Surgery Today. 2020;50:995-1001
https://link.springer.com/article/10.1007/s00595-020-01981-0

Published in 2019

41.Madani A, Grover K, & Watanabe Y. Measuring and Teaching Intraoperative Decision-Making Using the Visual Concordance Test. JAMA Surg. 2020;155:78-79
http://doi.org/10.1001/jamasurg.2019.4415

42.Yokoyama S, et al. Evaluation methods and impact of simulation-based training in pediatric surgery: a systematic review. Pediatr Surg Int. 2019;35:1085-1094
https://www.ncbi.nlm.nih.gov/pubmed/31396735

43.Mathis R, Watanabe Y, et al. What are the skills that represent expert-level laparoscopic suturing? A Delphi Study. Surg Endosc. 2020;34:1318-1323.
https://www.ncbi.nlm.nih.gov/pubmed/31214806

44.Mizota T, et al. Development of a fundamentals of endoscopic surgery proficiency-based skills curriculum for general surgery residents. Surg Endosc. 2020 34:771-778
https://www.ncbi.nlm.nih.gov/pubmed/31102077

45.Poudel S, et al. A snapshot of surgical resident training in Japan: results of a national-level needs assessment survey. Surg Today. 2019;49:870-876
https://www.ncbi.nlm.nih.gov/pubmed

46.Poudel S, et al. Identifying the Essential Portions of the Skill Acquisition Process Using Item Response Theory. J Surg Educ. 2019;76:1101-1106
https://doi.org/10.1016/j.jsurg.2019.01.015

47.Kurashima Y, et al. Development of a novel tool to assess skills in laparoscopic gastrectomy using the Delphi method: the Japanese operative rating scale for laparoscopic distal gastrectomy (JORS-LDG). Surg Endosc. 2019;33:3945-3952
https://www.ncbi.nlm.nih.gov/pubmed/30756172

48.Yokoyama S, et al. Identifying the needs for teaching fundamental knowledge of laparoscopic surgery: a cross-sectional study in Japan. Surg Endosc. 2019;33:2242-2248
https://www.ncbi.nlm.nih.gov/pubmed/30350098

49.Mizota T, et al. Surgeons see anatomical structures faster and more accurately compared to novices: Development of a pattern recognition skill assessment platform.Am J Surg. 2019;217:222-227
https://www.ncbi.nlm.nih.gov/pubmed/30482478

Published in 2018

50.Poudel S, et al. Development of a novel training system for laparoscopic inguinal hernia repair. Minim Invasive Ther Allied Technol. 2018;11:1-7
https://www.ncbi.nlm.nih.gov/pubmed/30204525

51.Bilgic E, Endo S, Lebedeva E, Takao M, McKendy KM, Watanabe Y, Feldman LS, Vassiliou MC. A scoping review of assessment tools for laparoscopic suturing.
https://www.ncbi.nlm.nih.gov/pubmed/29721749

52.Bilgic E, Takao M, Kaneva P, Endo S, Takao T, Watanabe Y, McKendy KM, Feldman LS, Vassiliou MC. Development of a Model for the Acquisition and Assessment of Advanced Laparoscopic Suturing Skills Using an Automated Device.
https://www.ncbi.nlm.nih.gov/pubmed/29557252

53.Mizota T, et al. Step-by-step training in basic laparoscopic skills using two-way web conferencing software for remote coaching: a multicenter randomized controlled study. Am J Surg. 2018;216:88-92.
https://www.ncbi.nlm.nih.gov/pubmed/29268939

54.McIlhenny C, Kurashima Y, et al. General surgery education across three continents. Am J Surg. 2018;215:209-213.
https://www.ncbi.nlm.nih.gov/pubmed/29246406

55.Poudel S, et al. Educational system based on the TAPP checklist improves the performance of novices: A multicenter randomized trial. Surg Endosc. 2018;32:2480-2487
https://www.ncbi.nlm.nih.gov/pubmed/29124407

Published in 2017

56.Poudel S, et al. Impact of 3D in the training of basic laparoscopic skills and its transferability to 2D environment: a prospective randomized controlled trial. Surg Endosc 2017;31:1111-1118
https://www.ncbi.nlm.nih.gov/pubmed/27351662

57.Watanabe Y, et al. Psychometric Properties of the Global Operative Assessment of Laparoscopic Skills (GOALS) using Item Response Theory. Am J Surg. 2017;213:273-276
https://www.ncbi.nlm.nih.gov/pubmed/27776756

58.Bilgic E*, Watanabe Y*, et al. Multicenter Proficiency Benchmarks for an Advanced Laparoscopic Surgery Curriculum. Am J Surg 2017;213:217-221 *co-primary author
https://www.ncbi.nlm.nih.gov/pubmed/27776755

59.Kurashima Y, et al. Systematic Review of the Implementation of Simulation Training in Surgical Residency Curriculum. Surgery Today 2017;47:777-782
http://link.springer.com/article/10.1007/s00595-016-1455-9

60.Watanabe Y, et al. Don’t Fix It If It Isn’t Broken: A Survey of Preparedness for Practice among Graduated Fellows. Surg Endosc 2017;31:2287-2298
https://www.ncbi.nlm.nih.gov/pubmed/27743124

Published in 2016

61.Poudel S., et al. Evaluation of hands-on seminar for reduced port surgery using fresh porcine cadaver model. J Minim Access Surg. 2016;12:214-219
https://www.ncbi.nlm.nih.gov/pubmed/27279391

62.Kurashima Y, et al. Where do we start? The first survey of surgical residency education in Japan. Am J Surg 2016;211:405-410
http://www.sciencedirect.com/science/article/pii/S0002961015005668

63.Poudel S, et al. Development and validation of a checklist for assessing recorded performance of laparoscopic inguinal hernia repair. Am J Surg, 2016;212:468-474
https://www.ncbi.nlm.nih.gov/pubmed/26750607

64.Watanabe Y, et al. New Models for Advanced Laparoscopic Suturing: Taking It to the Next Level. Surg Endosc 2016;30:581-587
https://www.ncbi.nlm.nih.gov/pubmed/26017911

65.Watanabe Y, et al. Surgeons Have Knowledge Gaps in the Safe Use of Energy Devices: a Multicenter Cross-Sectional Study. Surg Endosc 2016;30:588-592
https://www.ncbi.nlm.nih.gov/pubmed/26017912

66.Watanabe Y, et al. A Systematic Review of Performance Assessment Tools for Laparoscopic Cholecystectomy. Surg Endosc 2016;30:832-844
https://www.ncbi.nlm.nih.gov/pubmed/26092014

Published in 2015

67.Bilgic E*, Watanabe Y*, et al. Reliable assessment of Performance in Surgery: A practical approach to Generalizability Theory. J Surg Educ 2015; 72:774-775 *co-primary author
https://www.ncbi.nlm.nih.gov/pubmed/26117079

68.Watanabe Y, et al. Camera navigation and cannulation: validity evidence for new educational tasks to complement the Fundamentals of Laparoscopic Surgery Program. Surg Endosc 2015; 29:552-557
https://www.ncbi.nlm.nih.gov/pubmed/25034381

Published in 2014

69.Kurashima Y,et al.Simulation-based training improved the operative performance of totally extraperitoneal (TEP) laparoscopic inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc 201; 29:552-557

Book Chapters

1.Watanabe Y, et al. (2019). Objective metrics in the simulation of minimally invasive surgery In Daniel B. Jones, M.D., Steven Schwaitzberg, M.D. (Eds.), Operative Endoscopic and MIS. CRC Press; 2019 Chapter 30, 184-187.
https://www.amazon.co.jp/dp/B07PH29C8P/ref=cm_sw_r_oth_api_i_UDpnDb8CP3A2J

2.Mizota T, et al. Fundamentals of Robotic Surgery. In: Palazzo F, editor. Fundamentals of General Surgery. Springer; 2018 Chapter 16, 215-225
https://www.springer.com/gp/book/9783319756554

1.Global Operative Assessment for Laparoscopic Skills- Groin Hernia (GOALS－GH)：
（⇒ GOALS-GH（PDF））

2.TAPP Checklist：Assessment tool of Laparoscopic inguinal hernia repair (TAPP approach). Can be used to assess the video recording of the procedure
（⇒ TAPP Checklist（PDF））

3.TAPP Educational Video：Based on TAPP Checklist (In Japanese)（https://www.youtube.com/watch?v=gc1MULyp11g&t=1271s)

4.Japan Operative Rating Scale- Laparoscopic Distal Gastrectomy (JORS-LDG)：Assessment tool of laparoscopic distal gastrectomy. Useful for checking each step of the procedure.
（⇒ JORS-LDG Assessment sheet（PDF））

5.SAGES FUSE　Hands on seminar（https://www.kibanken.org/fuse）

• 2016-2018：Tomoko Mizota (Department of Surgery, Indiana University School of Medicine, IN, US)
• 2015-2016：Saseem Poudel (Surgical Education Research Fellowship: Association for Surgical Education)
• 2012-2015：Yusuke Watanabe（Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Canada）
• 2009-2012：Yo Kurashima（Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Canada）