Transforming surgical ward rounds: constructivist pedagogy, structured models, and intelligent technologies.

Surgical ward rounds are central to clinical training but often fail to engage learners as active participants. Traditional apprenticeship models leave teaching unstructured and variable, while clinical pressures compress time available for education. This review examines three interconnected developments that offer a way forward: constructivist learning theories that explain why active engagement matters, structured teaching models that translate theory into practice, and intelligent technologies that expand what is possible. SNAPPS (Summarize, Narrow, Analyze, Probe, Plan, Select), the One-Minute Preceptor (OMP), and the BID (Briefing, Intraoperative, Debriefing) framework each operationalize constructivist principles in different clinical contexts. Preliminary evidence from recent trials suggests that SNAPPS may improve clinical reasoning and case presentation quality, while OMP appears to achieve higher learner satisfaction in time-pressed settings. Generative artificial intelligence (AI) tools, in exploratory studies, can simulate consultant-level questioning before rounds and support consolidation afterwards. Immersive virtual reality (IVR) offers scalable skills training with potential long-term knowledge retention. Yet these technologies introduce concerns about accuracy, over-reliance, and algorithmic bias that governance frameworks are only beginning to address. Drawing on the evidence, an integrated framework is proposed that positions theory as the foundation, structured models as the methodology, and technology as an empowering tool. The field now needs multi-center studies with standardized outcomes, longer follow-up, and systematic investigation of how AI and VR combine with established teaching frameworks.