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Innovation and Change in Professional Education 17

Debra Nestel
Kirsten Dalrymple
John T. Paige
Rajesh Aggarwal Editors

Advancing
Surgical
Education
Theory, Evidence and Practice
Innovation and Change in Professional
Education

Volume 17

Series editor

Wim H. Gijselaers, School of Business and Economics, Maastricht University,

The Netherlands

Associate editors

L.A. Wilkerson, Dell Medical School at the University of Texas at Austin, TX, USA
H.P.A. Boshuizen, Center for Learning Sciences and Technologies,
Open Universiteit Nederland, Heerlen, The Netherlands

Editorial Board

Eugene L. Anderson, Anderson Policy Consulting & APLU, Washington, DC, USA
Hans Gruber, Institute of Educational Science, University of Regensburg,
Regensburg, Germany
Rick Milter, Carey Business School, Johns Hopkins University, Baltimore, MD, USA
Eun Mi Park, JH Swami Institute for International Medical Education,
Johns Hopkins University School of Medicine, Baltimore, MD, USA
SCOPE OF THE SERIES

The primary aim of this book series is to provide a platform for exchanging
experiences and knowledge about educational innovation and change in professional
education and post-secondary education (engineering, law, medicine, management,
health sciences, etc.). The series provides an opportunity to publish reviews, issues
of general significance to theory development and research in professional education,
and critical analysis of professional practice to the enhancement of educational
innovation in the professions.
The series promotes publications that deal with pedagogical issues that arise in the
context of innovation and change of professional education. It publishes work from
leading practitioners in the field, and cutting edge researchers. Each volume is
dedicated to a specific theme in professional education, providing a convenient
resource of publications dedicated to further development of professional education.

More information about this series at http://www.springer.com/series/6087

Debra Nestel • Kirsten Dalrymple • John T. Paige
Rajesh Aggarwal
Editors

Advancing Surgical
Education
Theory, Evidence and Practice
Editors
Debra Nestel Kirsten Dalrymple
Faculty of Medicine, Nursing & Health Faculty of Medicine
Sciences, Monash Institute for Health Imperial College London
and Clinical Education London, UK
Monash University
Clayton, VIC, Australia Rajesh Aggarwal
Department of Surgery, Sidney Kimmel
Faculty of Medicine Dentistry & Health
Medical College
Sciences, Department of Surgery,
Thomas Jefferson University
Melbourne Medical School
Philadelphia, PA, USA
University of Melbourne
Parkville, Australia Jefferson Strategic Ventures
Jefferson Health
John T. Paige Philadelphia, PA, USA
Department of Surgery
Louisiana State University School
of Medicine
New Orleans, LA, USA

ISSN 1572-1957     ISSN 2542-9957 (electronic)

Innovation and Change in Professional Education
ISBN 978-981-13-3127-5    ISBN 978-981-13-3128-2 (eBook)
https://doi.org/10.1007/978-981-13-3128-2

© Springer Nature Singapore Pte Ltd. 2019

This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims
in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721,
Singapore
Foreword by Richard Canter

This book is a timely and exciting addition to the surgical education literature. Let
me explain why. The last 30 years or so has seen a transformation in surgical educa-
tion with three distinct elements of change: organisational to university-based sys-
tems of quality, provider to demand-led delivery of service and surgeon to
surgeon-educator. Arguably the most important of these has been surgeon to
surgeon-­educator because of the ability to scale up excellence. A highly skilled
surgeon may, for example, complete 10,000 operations in a career and hopefully
bring improvements to 10,000 patients. If at the same time they develop 20 surgical
trainees to the same level of excellence, who themselves go onto complete 10,000
operations, then the spread of excellence is exponentially increased. The point is
rapidly approaching when surgeons not only develop other surgeons to a standard of
excellence but also pass on the educational skills for them to do the same. This
means that there is the potential over a surgical generation or two for the excellent
practice of a single surgeon to influence thousands or even millions of patients. So
far, so good. Unfortunately, the same argument can be applied to the spread of poor
practice and the capacity to do harm. This is the reason why research into surgical
education, and how to develop excellence in yourself and others, is so important.
This book is not only timely but also important for patient welfare.
The discipline of surgical education has spawned a real and increasing interest in
education theory, practice and research with many choosing to adopt significant
roles as educators in their institutions. The four editors have identified expertise
from experienced researchers and brought together a set of fascinating chapters
linking practice, theory, evidence and research methods. For anyone interested in
surgical education, and in particular in education research, this has got to be a first
choice book to read. Why? Because the breathtaking range of topics that now cover
the field of surgical education will disturb some basic assumptions about relevant
topic, what constitutes evidence, the choice of research paradigm, the selection of
methodology and relevant literature so will encourage you to go on an intellectual

v
vi Foreword by Richard Canter

journey of discovery. Don’t be surprised if one evening you find yourself reading
philosophers like Foucault and others and enjoying the challenge of new unexpected
ideas that are relevant to surgery. Surgery, surgical education and surgeons have all
changed so much in such a short time, and yet this is only the beginning.

Nuffield Department of Surgery Richard Canter

University of Oxford
Oxford, UK
Foreword by Christopher Christophi

The concept and the need of a textbook specifically on surgical education was envis-
aged and developed following the recognition of the global and broader need for
professional development in health professions education.
The Royal Australasian College of Surgeons and the University of Melbourne’s
Department of Surgery have implemented the highly successful graduate pro-
grammes in surgical education, initiated by Prof. John Collins and implemented by
one of the editors of this book – Prof. Debra Nestel. This book is a logical sequela
to these programmes and makes compelling reading for any person committed to
surgical education and aspires to leadership in this rapidly expanding field. The edi-
tors have brought together an outstanding group of contributors comprising experi-
enced, internationally recognised authors and national contributors comprehensively
addressing concepts and topics pertaining to surgical education.
Apart from being a knowledge and reference resource, this pioneering book is
global in perspective, provocative and challenges established dogma. It is divided
into five sections and follows a sequence initially addressing governance and theo-
ries of surgical education and the practical aspects faced by those at the coalface of
this specialty. It concludes by addressing research aspects and the future
directions.
This book will prove to be an indispensable armamentarium to those involved in
this evolving field and reflects the expertise and enthusiasm of the editors and
contributors.

Department of Surgery Christopher Christophi

University of Melbourne
Parkville, VIC, Australia

vii
Foreword by Carlos Pellegrini

The focus of Advancing Surgical Education: Theory, Evidence and Practice is on

residency and post-residency training. Recognizing that most of the training and
education of surgeons is done by surgeons and that most surgeons are not necessar-
ily equipped with the skills and knowledge needed to provide the most effective and
efficient education and training to their trainees, the book is intended to fill this gap
with a comprehensive description of the theories, the evidence and the practice of
modern surgical education. Each of the five parts of the book provides unique
insights into a different aspect related to education. The first part deals with a lot of
the historical aspects, the role of leadership and governance in surgical education.
The second part of the book delves deeply into the theories that underpin educa-
tional practices. It explores the science of learning and the science of teaching, and
while this portion of the book will certainly appeal to those who are in charge of
teaching programmes, I believe some of its chapters (like the role of power in surgi-
cal education, the construction of the surgeon identity, etc.,) will equally be of inter-
est to those surgeons in the trenches – those that are involved in the daily teaching
of residents and fellows. The third part of the book, dedicated to the practice of
surgical education, is in itself a complete compendium dealing with the design and
implementation of surgical education and training activities at the intersection of
service and education. It provides advice on recruitment, on the role of feedback, on
the role of assessment all the way to certification and revalidation, on the manage-
ment of underperformance and on training and safety and is a “must” for everyone
involved, including the trainees themselves. The fourth part of the book deals with
research in surgical education, and this portion reflects the background and extraor-
dinary expertise of the editors themselves, assembled from some of the best pro-
grammes around the world. This part of the book is recommended to young faculty
members who wish to start their scholarly involvement in the field of education. The
last part of the book describes the future state of surgical education and training and

ix
x Foreword by Carlos Pellegrini

provides a “destination postcard” for 2030. All in all, this book provides a plethora
of information and guidance that will serve surgeon-teachers around the world in
the years to come.

Professor, Department of Surgery

Carlos Pellegrini
University of Washington
Seattle, WA, USA
Chief Medical Officer
UW Medicine
Seattle, WA, USA
Vice-President for Medical Affairs
University of Washington
Seattle, WA, USA
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Contents

1 Celebrating Surgical Education..............................................................    1

Debra Nestel, Kirsten Dalrymple, and John T. Paige

Part I Overview: Foundations of Surgical Education

2 Surgical Education: A Historical Perspective.......................................    9
Roger Kneebone
3 The Contemporary Context of Surgical Education..............................   17
Adrian Anthony and Vijayaragavan Muralidharan
4 Surgical Education Leadership and the Role of the Academy............   33
Peter Gogalniceanu, Margaret Hay, and Nizam Mamode
5 The Governance of Surgical Education: The Role of the Colleges......   45
Ian Eardley

Part II Overview: Theories Informing Surgical Education

6 Cognitive Neuroscience and Design of Surgical Education.................   57
David Bartle and Andrew Evans
7 Expertise Theories and the Design of Surgical Education...................   69
Alexander Harris
8 Helping Learners Through Transitions: Threshold Concepts,
Troublesome Knowledge and Threshold Capability
Framework in Surgery............................................................................   79
Simon Blackburn, Julian Smith, and Debra Nestel
9 Communities of Practice and Surgical Training...................................   95
Tasha A. K Gandamihardja and Debra Nestel
10 Activity Theory and the Surgical Workplace........................................   105
Edward F. Ibrahim

xi
xii Contents

11 The Role of Power in Surgical Education:

A Foucauldian Perspective......................................................................   115
Nancy McNaughton and Ryan Snelgrove
12 Constructing Surgical Identities: Being and Becoming a Surgeon.....   123
Roberto Di Napoli and Niall Sullivan
13 Constructing Surgical Identities: Becoming a Surgeon Educator......   133
Tamzin Cuming and Jo Horsburgh

Part III Overview: The Practice of Surgical Education

14 Designing Surgical Education Programs...............................................   145
Jennifer Choi and Dimitrios Stefanidis
15 Selection into Surgical Education and Training....................................   157
John P. Collins, Eva M. Doherty, and Oscar Traynor
16 Models of Teaching and Learning in the Operating Theatre...............   171
Alexandra Cope, Jeff Bezemer, and Gary Sutkin
17 Supporting the Development of Psychomotor Skills............................   183
Pamela Andreatta and Paul Dougherty
18 Patients and Surgical Education: Rethinking Learning,
Practice and Patient Engagement...........................................................   197
Rosamund Snow, Margaret Bearman, and Rick Iedema
19 The Role of Verbal Feedback in Surgical Education............................   209
Elizabeth Molloy and Charlotte Denniston
20 The Role of Assessment in Surgical Education.....................................   221
P. Szasz and T. P. Grantcharov
21 Entrustable Professional Activities in Surgical Education...................   229
Stephen Tobin
22 Revalidation of Surgeons in Practice.....................................................   239
Ajit K. Sachdeva
23 Demystifying Program Evaluation for Surgical Education.................   255
Alexis Battista, Michelle Yoon, E. Matthew Ritter,
and Debra Nestel
24 Simulation in Surgical Education...........................................................   269
Rajesh Aggarwal
25 Developing Surgical Teams: Theory.......................................................   279
John T. Paige
26 Developing Surgical Teams: Application...............................................   289
John T. Paige
Contents xiii

27 Supporting the Development of Professionalism in Surgeons

in Practice: A Virtues-Based Approach to Exploring
a Surgeon’s Moral Agency......................................................................   303
Linda de Cossart CBE and Della Fish
28 Managing Underperformance in Trainees.............................................   313
Jonathan Beard and Hilary Sanfey
29 Patient Safety and Surgical Education..................................................   327
S. D. Marshall and R. M. Nataraja

Part IV Research in Surgical Education

30 Researching in Surgical Education: An Orientation............................   341
Rola Ajjawi and Craig McIlhenny
31 Researching in Surgical Education: A Surgeon Perspective................   353
Rhea Liang
32 From Dense Fog to Gentle Mist: Getting Started
in Surgical Education Research..............................................................   363
Deb Colville and Catherine Green
33 Reviewing Literature for and as Research............................................   377
Nigel D’Souza and Geoff Wong
34 Measuring the Impact of Educational Interventions:
A Quantitative Approach........................................................................   389
Jenepher A. Martin
35 Understanding Learning: A Qualitative Approach..............................   405
Kirsten Dalrymple and Debra Nestel
36 Ethical Issues in Surgical Education Research.....................................   423
Martyn Kingsbury
37 Remaining “Grounded” in a Laparoscopic Community
of Practice: The Qualitative Paradigm..................................................   439
Rory Kokelaar
38 The Nature of Nurture in Surgery: A Drama in Four
Acts (So Far).............................................................................................   445
David Alderson
39 Approaching Surgery Simulation Education from
a Patient-Centered Pathway...................................................................   451
Kiyoyuki Miyasaka
xiv Contents

Part V Future Directions in Surgical Education

40 Surgical Education in the Future...........................................................   459
Prem Rashid and Kurt McCammon
41 Finally, the Future of Surgical Educators..............................................   469
Debra Nestel, John T. Paige, and Kirsten Dalrymple

Index..................................................................................................................   483
Chapter 1
Celebrating Surgical Education

Debra Nestel, Kirsten Dalrymple, and John T. Paige

Overview The surgeon as educator faces the challenges of adequately preparing the
next generation of surgeons while maintaining a busy practice and keeping up with
the latest developments and innovations of the field through familiarity with best
evidence in literature. This book helps with keeping up with the latest best evidence
in education research and theory. As surgical care has a universal component related
to the responsibility entrusted to the surgeon and the healing through combination of
mind and hand, so too surgical education involves disseminating knowledge as well
as skill. This book aims to address knowledge of surgical education. In this chapter,
we share drivers for the book and personal perspectives that inform its shape. We
also acknowledge the many influences on our own thinking and practices.

1.1 Introduction

Surgical education is in an exciting phase. This book celebrates some of its many
achievements. In this chapter, we summarise key influencing factors in the develop-
ment of this book, and we share personal perspectives and orientate readers to the
content.

D. Nestel (*)
Faculty of Medicine, Nursing & Health Sciences, Monash Institute for Health and Clinical
Education, Monash University, Clayton, VIC, Australia
Faculty of Medicine Dentistry & Health Sciences, Department of Surgery, Melbourne
Medical School, University of Melbourne, Parkville, Australia
e-mail: [email protected]; [email protected]
K. Dalrymple
Faculty of Medicine, Imperial College London, London, UK
e-mail: [email protected]
J. T. Paige
Department of Surgery, Louisiana State University School of Medicine,
New Orleans, LA, USA
e-mail: [email protected]

© Springer Nature Singapore Pte Ltd. 2019 1

D. Nestel et al. (eds.), Advancing Surgical Education, Innovation and Change
in Professional Education 17, https://doi.org/10.1007/978-981-13-3128-2_1
2 D. Nestel et al.

Several factors influenced the initiation and development of this book. The shift-
ing orientation of surgical education from an apprentice-based model to a
competency-­based one with interim variations has created an opportunity for the
discipline to grow. This has occurred at a time with parallel development in theories
that inform educational practice. These theories offer frameworks to make meaning
of and guide educational program design, implementation and evaluation. During
the last 30 years, there has been significant development in educational theories and
practices, many of which have been ‘overlooked’ by surgical educators who have
remained rooted solely in an apprenticeship model.
This book provides opportunities to access a broad range of theories – some
theories enable us to take a macro view of practice (social/cultural/political), while
others focus on the micro (individual as learner and/or teacher). We include offer-
ings across this spectrum. These new opportunities to view surgical education as
something amenable to structure, measurement, standardisation and examination
through educational theory have moved the field forward. It has become fairer, safer
and more knowledgeable of itself, in many regards, but these advances have some-
times come with costs and a realisation of the limitations of, for example,
competency-­based education. There is a growing recognition, and some might
rightly call a reassertion of the importance of fostering meaningful, trusting, social
relationships between learners and teachers as a basis for growing trainee surgeons’
surgical judgement and skill and for considering their progress. Taking more holis-
tic views of expertise, of what constitutes surgical ‘community’, and of surgery’s
end goal of improving the health and well-being of patients brings us back to con-
sidering the role of trust, not only as a facet of professional practice but of educa-
tional practice. If we subscribe to the argument that this is where significant
development happens, for both educators and trainees, our efforts to understand and
improve our practice as educators must also embrace the social, the cultural and the
individual as a person. That this parallels arguments around the care of patients is
not coincidental.
Being a surgical educator today affords new opportunities to develop an identity
that goes beyond what it did in the past. It adds a knowledge-based, skill-based and
the critical judgement of another professional practice to surgery’s existing training
traditions – it adds the field of education. Bringing the field of education to the sur-
gical educator provides a wider repertoire of tools with which to examine difficult
and complex educational problems.
With the professionalisation of surgical education comes greater acknowledge-
ment and recognition of its expertise. This has become more evident through the
development of standards for practice such as those published by the Faculty of
Surgical Trainers in Edinburgh in 2014 [1]. In Australia, the Academy of Surgical
Educators was launched in 2013 and seeks to ‘foster excellence’ [2]. In 2017, the
American College of Surgeons established the Academy of Master Surgeon
Educators which will function as a ‘think tank’ seeking to improve the quality of
surgical education. Annual and biannual conferences in surgical education are focal
events for surgical education scholars and educators – the International Conference
on Surgical Education and Training (ICOSET) and the United States-based
1 Celebrating Surgical Education 3

Box 1.1 Examples of Journals Where Surgical Education Research May

Be Published (Excluding Surgical Clinical Journals)
1. Academic Medicine http://journals.lww.com/academicmedicine/pages/
default.aspx
2. Advances in Health Sciences Education http://www.springer.com/
education+&+language/journal/10459
3. BMC Medical Education http://www.biomedcentral.com/bmcmededuc
4. Journal of Surgical Education http://www.sciencedirect.com/science/
journal/19317204
5. Medical Education http://www.mededuc.com/ or http://www.wiley.com/
bw/journal.asp?ref=0308-0110
6. Medical Teacher http://www.medicalteacher.org/MEDTEACH_wip/
pages/home.htm
7. Perspectives on Medical Education http://www.springer.com/
education+%26+language/journal/40037
8. Teaching and Learning in Medicine http://www.siumed.edu/tlm/
9. The Clinical Teacher http://www.theclinicalteacher.com/

Association for Surgical Education (ASE) Conference. Although the landscape of

surgical education differs internationally, this also provides opportunities to learn
from each other. There is a growing body of specialist surgical education literature
with edited books such as Fry and Kneebone [3], a collection of readings from theo-
rists, researchers and practitioners (surgery and education), and, from Pugh and
Sippel [4], a ‘practical’ guide to establishing a surgical education career in the
United States. There are also several peer- reviewed health professions education
journals that publish research from the surgical education research community (Box
1.1). These initiatives of communities of practice illustrate just how far surgical
education has come in a relatively short time.
Graduate programs in health professions and clinical education are now quite
common. Although surgical practice shares many features and concerns with other
health professions, there is also a recognition of its highly specialised nature, and,
hence, programmes designed for surgical educators have been offered, for example,
at Imperial College London since 2005 [5] and through the University of Melbourne
and the Royal Australasian College of Surgeons (RACS) since 2012 [6]. Like gradu-
ates with interests in surgical education from other programs, they usually under-
take research that is adding to understanding ways in which surgical education is
practised internationally. An important driver for this book is the provision of a
reference book for students embarking on higher degrees where surgical education
is a focus. We acknowledge that navigating this landscape can be challenging and
thoughtfully described by Kneebone (2002) in his essay on internal reflection [7]. In
this he describes the challenges of making meaning of the education literature after
training in a biomedical positivist tradition.
4 D. Nestel et al.

This book sits in the Springer series: Innovation and Change in Professional
Education. This is a logical home for several reasons. At its heart, the book is about
innovation. Authors have been invited to contribute because of their innovative and
often critical positioning and philosophising about ways to support the next genera-
tion of surgeons. The landscape of surgical practice and education is a dynamic one.
This sort of change is inevitable and welcomed, as the community whose needs are
to be met by the profession, and those who are to meet them also change. And,
although surgery is a professional practice, the education of surgeons has often been
of low value in departments of surgery. Surgical education has not been seen as
requiring the development of educational expertise. This aligns with privileging the
language of surgical training over surgical education in common parlance. Our posi-
tion is that the responsibility of those charged with supporting the development of
the next generation of surgeons needs more than a training focus. They also require
a deep and deliberate consideration of values about teaching and learning. This
book provides an opportunity to prompt critical reflection on the values and prac-
tices associated with surgical education.
In its very construction, the book attempts to model the bringing together of
surgical education perspectives and the nurturing of a new generation of surgical
education scholars. The authors are drawn from various parts of the globe and are
comprised of teams of surgeons and academics from education, the social sciences
and more. With their different backgrounds and perspectives come forms of writing
and argument that may vary from those with which you are more familiar. We invite
you to explore these varied ways of communicating knowledge and challenge you
to make links with more familiar approaches. We believe that this book goes beyond
those before it in its breadth, depth and examination of surgical education practices
and the ways in which they are communicated.

1.2 Our Editorial Team

Our editorial team came together through our links with Imperial College London,
three of us (DN, KD, RA) having worked at Imperial for extended periods, and JP
has undertaken research with colleagues based at Imperial. Collectively, we have
expertise in various facets of education and surgical knowledge and practice. During
the development of this book, we have been living and working across four coun-
tries – Australia (DN), the United Kingdom (UK) (KD), Canada (RA) and the
United States of America (USA) (JP and RA) – and we are all actively involved in
surgical education.
Debra Nestel PhD FSSH has worked in surgical education for about 10 years and
broader health professions education for over 30 years, in Hong Kong, London and
Melbourne. Currently Professor of Surgical Education, Department of Surgery,
University of Melbourne, and Professor of Simulation Education in Healthcare,
Monash University, Australia, Debra spends her time approximately equally in edu-
cation research and practice. She is Co-Director of the Graduate Programs in
1 Celebrating Surgical Education 5

Surgical Education and the Graduate Programs in Surgical Science. After Professor
John Collins, then Dean of Education, RACS, had a proposal for post-graduate
qualifications in surgical education approved, Debra was tasked with its implemen-
tation. A core reference book was an important driver for this project. Debra’s first
degree was in sociology, and this seeps through much of her current practice. She
has a strong interest in simulation, especially simulated patient methodology and in
faculty development. Debra mainly conducts qualitative research while appreciat-
ing the role of all research paradigms to address the broad range of questions rele-
vant to surgical education. She has also edited books on simulated patient
methodology and healthcare simulation and is editor-in-chief of the open access
journal, Advances in Simulation, the journal of the Society in Europe for Simulation
Applied to Medicine. She holds service roles in many professional organisations.
Kirsten Dalrymple, PhD, is Principal Teaching Fellow and Course Co-Director,
Master’s in Education in Surgical Education, Department of Surgery and Cancer,
Faculty of Medicine, Imperial College London. She has worked in health profes-
sions education for over 15 years, having trained initially as a biomedical scientist.
Before working in the United Kingdom, Kirsten played a lead role in major curricu-
lar changes and faculty development at the University of Southern California’s
School of Dentistry. She has been a key figure in the execution and ongoing devel-
opment of Imperial’s Master’s in Surgical Education since 2008, having had the
opportunity to work closely as tutor and research supervisor for surgeons from dif-
ferent countries, specialties and at different stages of their careers. Her work with
clinical colleagues and her own scientific background have shaped her interest in
how values and views of knowledge impact educational practice and have provided
her with motivation to build links between education and surgery. She is currently
working on a pedagogic project exploring how failure and mistakes are perceived
by different disciplines, including surgery, and the impact this has on professional
development. She serves on two of Imperial’s educational research ethics
committees.
John Paige MD, FACS, joined the Department of Surgery at Louisiana State
University (LSU) School of Medicine in New Orleans in 2002 where he has prac-
ticed general and minimally invasive surgery. Currently, he is Professor of Clinical
Surgery with additional appointments in the Departments of Anesthesiology and
Radiology. He serves as both overall and surgical director of the American College
of Surgeons Accredited Comprehensive Education Institute, the LSU Health New
Orleans School of Medicine Learning Center. John has dedicated his academic
career to surgical education and research. His published work in simulation and
surgical education related to skills acquisition and interprofessional team training
has led him to present nationally and internationally. He is an active member of
several national surgical society simulation, education and faculty development
committees, holding leadership positions. He is coeditor of a book on simulation in
radiology. He has been a coinvestigator on federally funded grants exploring team
training. John’s areas of interest include simulation-based skills training, interpro-
fessional education, team training, human factors, patient safety and debriefing.
6 D. Nestel et al.

Rajesh Aggarwal MD PhD FRCS FACS is a surgeon and educator. He trained as

a surgeon in the United Kingdom and has held academic and clinical posts at
Imperial College London, University of Pennsylvania and most recently at McGill
University where he was also charged as director of the Steinberg Centre for
Simulation and Interactive Learning. In 2002, he completed a PhD degree in virtual
reality technologies for surgical education. In 2017, Rajesh has taken on his role in
strategic business development at Thomas Jefferson University and Jefferson
Health.

1.3 Conclusion

In closing this chapter, we acknowledge many of those who have influenced our
thinking and practices, some of whom are contributors to this book. The five sec-
tions of the book commence with orientation notes offering linkages between the
varied contributions. We hope you enjoy the contents of this book as much as we
have in working with our colleagues from around the world in assembling examples
of their scholarship. Time to celebrate.

References

1. McIlhenny, C., & Pitts, D. (2014). Standards for surgical trainers Edinburgh: Royal college
of surgeons Edinburgh. Available from: https://fst.rcsed.ac.uk/standards-for-surgical-trainers.
aspx
2. Royal Australasian College of Surgeons. (2017). Academy of surgical educators. [Cited
2017 November 11]. Available from: https://www.surgeons.org/for-health-professionals/
academy-of-surgical-educators/
3. Fry, H., & Kneebone, R. (2011). Surgical education: Theorising an emerging domain. London:
Springer.
4. Pugh, C., & Sippel, R. (2013). Success in academic surgery: Developing a career in surgical
education. London: Springer.
5. Imperial College London. MEd surgical education. [Cited 2017 November 11]. Available
from: https://www.imperial.ac.uk/medicine/study/postgraduate/masters-programmes/
med-surgical-education/
6. University of Melbourne and Royal Australasian College of Surgeons. Master of surgical
education. [Cited 2017 November 11]. Available from: https://coursesearch.unimelb.edu.au/
grad/1865-master-of-surgical-education
7. Kneebone, R. (2002). Total internal reflection: An essay on paradigms. Medical Education,
36(6), 514–518.
Visit https://textbookfull.com
now to explore a rich
collection of eBooks, textbook
and enjoy exciting offers!
 Part I
Overview: Foundations of Surgical
Education

The first part of this book explores foundations of surgical education from its his-
torical roots in apprenticeship to its transformation over time to address changes to
medicine, surgery, and wider society. As noted in the introduction to the book, con-
temporary surgical practice and education are dynamic entities that interact with
one another. In his historical perspective, Kneebone considers the relative certain-
ties of surgical education over the last century and how recent practices have resulted
in the current state of “fluidity and instability” (Chap. 2). He concludes this chapter
“reflecting on the continual process by which innovation becomes established as a
‘new normal,’ only to be overtaken in its turn by continuing change.” This offers
further justification for this book to be located in the series: Innovation and Change
in Professional Education.
Anthony and Muralidharan examine the shift to competency-based surgical
education from the long history of apprenticeship (Chap. 3). Using the context of
surgical training in Australia and New Zealand, they describe the Royal Australasian
College of Surgeons (RACS) and other institutional approaches to developing an
educationally aware community of surgical educators, essential to address contem-
porary drivers for surgical education. One important challenge is to balance the
increasing demands on the surgical education workforce while delivering an
expanded surgical curriculum that best serves the modern community. The authors
acknowledge an orientation to actively develop well-rounded surgeons, where the
“nontechnical” skills are valued alongside conventional and other characteristic
skills of operating. For many issues, they consider its impact at macro-, meso-, and
microlevels. Although their work has a regional context, many of the issues have
relevance globally.
From Gogainaceu et al., we learn of the support of leadership development in
surgical training (Chap. 4). This is an element of professional practice that has often
not formed part of traditional curricula. The authors describe how leadership and
education are similar transformative processes that “facilitate growth, foster
collaborations and increase scientific knowledge, innovation and enterprise.” They
also explore the role of academy in the development of leaders and educators and,
indeed, educational leaders.
8 I Overview: Foundations of Surgical Education

Quality in surgical education must have a central role and one manifestation is
governance. From a United Kingdom perspective, Eardley reviews the place of the
Surgical Royal Colleges in the governance of surgical training – in curriculum
development, assessment, selection, certification, quality assurance, and trainee
support (Chap. 5). Additionally, the chapter describes the complex and changing
relationship of the colleges with the regulator, the funder, and the education
providers.
In summary, this part offers a status check on where we have been and where we
are. Two focused topics that must be considered for developing excellence in
surgical education – leadership and governance – illustrate essential foundations for
change and quality.
Chapter 2
Surgical Education: A Historical
Perspective

Roger Kneebone

Overview This chapter considers how the landscape of surgical education has
changed over the past century and how the educational certainties of an earlier gen-
eration have been supplanted by fluidity and instability. After outlining the estab-
lishment of open surgery in the first half of the twentieth century, the chapter uses
the introduction of minimally invasive (keyhole) surgery in the 1980s as a lens for
examining the educational implications of surgical innovation and the processes by
which such innovation can trigger educational change. At the same time, the discus-
sion charts the emergence of professionalism of surgical education, shaped by
expert perspectives from outside medicine. This has led to a broadening of method-
ological approaches to the investigation of educational questions and the establish-
ment of surgical education as a scholarly field with its own identity. The chapter
concludes by reflecting on the continual process by which innovation becomes
established as a ‘new normal’, only to be overtaken in its turn by continuing change.

This chapter surveys how the landscape of surgical education has changed over the
past century and how contemporary challenges have been shaped by the past. In that
time, the surgical world – together with the sociopolitical world it responds to and
reflects – has become increasingly fluid and unstable. Disciplinary boundaries are
becoming blurred, and new technologies are overturning previously settled ways of
knowing and of doing. The focus of surgical education has shifted from learning
how to do things as they are already done to responding to (and moulding) a surgical
world that is in continual flux. A professionalisation of education has taken place
which has moved beyond the frame of surgical practice to include expert perspec-
tives from outside medicine. This has profound implications for what it means to be
a surgeon and a surgical educator.

R. Kneebone (*)
Department of Surgery and Cancer, Imperial College London, London, UK
e-mail: [email protected]

© Springer Nature Singapore Pte Ltd. 2019 9

D. Nestel et al. (eds.), Advancing Surgical Education, Innovation and Change
in Professional Education 17, https://doi.org/10.1007/978-981-13-3128-2_2
10 R. Kneebone

Two related developments – keyhole (minimally invasive) surgery and simulation-­

based training – provide the backdrop for a discussion about changes which have
shaped the landscape of today. This account will inevitably oversimplify a complex
picture. It presents the personal perspective of the author, a clinician who trained as
a surgeon in the 1970s and 1980s, became a general practitioner in the 1990s, and
has since specialised in surgical education at a large London university medical
school.
Surgery in its current form is rooted in the upheavals and discoveries of
eighteenth-­century Europe [1, 2]. At that time, Paris emerged as a major centre of
clinical innovation, while in Britain, the Hunter brothers (John and William) played
a pivotal role in establishing surgery as a scholarly discipline underpinned by rigor-
ous study. Wherever it was practised, a strong performative element to operative
surgery was prompted by the need (before the discovery of anaesthesia) for sur-
geons to be rapid and decisive and influenced by a history of anatomical and surgi-
cal performance reaching back to earlier centuries.
The next hundred years saw the establishment of ‘scientific’ surgery, influenced
by European (and especially German) practice. Advances in microbiology and bio-
chemistry transformed clinical practice, framing surgery as the application of scien-
tific knowledge and surgeons as applied scientists rather than performers. From the
mid-nineteenth century onwards, developments such as anaesthesia, antisepsis and
asepsis meant that previously inaccessible territories of the body could be safely
operated upon – first the abdomen, then the brain, the heart and beyond. Approaches
to investigation, diagnosis and treatment became increasingly influenced by the
laboratory, and the body became seen as a mechanism which could be fixed by
surgery.
At the same time, major changes were taking place in the landscape of clinical
education. Concerns about standards in American medical schools led to Abraham
Flexner’s overhaul of undergraduate medical training and brought much-needed
reforms. His report of 1910 sets standards for admission and graduation, highlight-
ing the importance of science in the curriculum [3]. This led to the closure of many
rural medical schools in America and laid the foundation for educational structures
which persist to this day. Postgraduate education too was in flux. For example, in the
late nineteenth century, the celebrated surgeon William Halsted introduced the con-
cept of a formal surgical residency at Johns Hopkins Hospital in Baltimore [4–6]. In
a model which became widely adopted and is still in place today, structured training
combined clinical experience with graded supervision.
In the United Kingdom, the establishment of the National Health Service in 1948
marked a later watershed. For the first time, medical care became available to all,
regardless of the ability to pay. In the decades that followed, surgical care was pro-
vided within a strong social professional framework. A clear hierarchical structure
(established in the aftermath of World War II and reflecting the social structures of
the time) was set in place. Education and training were central to this structure.
Surgical ‘firms’, each led by a consultant, consisted of close-knit groups of surgeons
in training who underwent an extended apprenticeship lasting many years. Almost
all out-of-hours care was provided by those in training, and trainees gained extensive
2 Surgical Education: A Historical Perspective 11

experience in operative surgery. The ‘firm’ system ensured continuity of care for
patients and offered a supportive and collegiate milieu for clinicians but required
high levels of commitment and exceptionally long hours of work. An important
effect of this demanding training was to develop a surgical identity amongst those
who underwent it – a shared sense of what it meant to ‘be’ a surgeon as well as to
do surgical work, as much about who a surgeon became as what he or she could do.
In contrast to undergraduate medical education, with its focus on curriculum and
formal learning, postgraduate surgical learning was assumed more than designed or
prescribed. Assessment of fitness to progress within the system was unsystematic,
opaque and based on the personal judgment of senior clinicians.
By the mid-twentieth century, surgery seemed to have reached a steady state. A
stable social structure for interaction between patients and professionals was taken
for granted, and – as with education in schools and universities more generally –
what was to be learned appeared fixed and unchanging. This approach represented
the wider sociopolitical context of the time, with its climate of deference and
­confidence in authority in general and in the medical profession in particular.
Publics and politicians trusted clinicians to design and oversee their own educa-
tional as well as clinical practice, and post-war social assumptions were clearly
visible.
By this time, surgical training had become well-established, with education
accepted as a by-product of clinical care. The assumption was that by working
within the healthcare system for long enough, a learner would eventually become
expert. The extended apprenticeship system provided enormous experience in the
skills of operating, while the ‘firm’ structure ensured that trainee surgeons became
versed in all aspects of patient care (including continuity between ward and theatre)
and became part of a close-knit (if closed and often inward-looking) professional
community. For surgeons, therefore, education and clinical care were inseparable.
There were few specific courses or programmes, and surgical learning took place
from within, as part of being a practitioner. Senior surgeons were expected to teach
in every aspect of their practice, from outpatient clinic and ward to operating theatre
and emergency room, but there was no overt surgical curriculum. Learning took
place by absorption, underpinned by an assumption that by the end of training,
trainees would have been exposed to sufficient breadth and depth of experience to
undertake full responsibility when they became consultants themselves. Professional
examinations were more about factual knowledge than practical skill.
By the 1980s, all this began to change. Part of this disruption was technological.
Discoveries and developments in areas such as imaging, energy sources, fibre optics
and miniaturisation led to new opportunities within operative surgery and medicine
as a whole. The power of surgery (until then confined to what could be done with
relatively simple instruments) became enormously enlarged. At the same time, a
shift from diagnosis to intervention meant that previously sharp distinctions between
surgery, medicine, radiology and other disciplines started to become smudged.
Intestinal endoscopy, for example, was developed by gastroenterologists and radi-
ologists, and surgeons were no longer the only group who carried out delicate inva-
sive procedures on patients.
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 CHAPTER IX
DEVELOPMENT OF IRON SHIPBUILDING

fter the launching of the Great Britain in 1845, steam-

ship building was carried on with great activity,
though the change from wood to iron and from
paddles to the screw was gradual. Many wooden
vessels, both steamers and sailers, continued to be
built, as the prejudice against iron for ship
construction died slowly. The screw propellers were
at first simply auxiliary to sail. This was due to three causes:
mistrust of the propeller, the cost of continually running it, and the
difficulty of carrying sufficient coal.
Describing the gradual evolution of the steam-ship in its early
days, Mr. John Ward, a director in Messrs. Denny’s famous firm, in
his Presidential Address to the Institution of Engineers and
Shipbuilders in Scotland, in 1907, said:
“The necessities of the screw propeller after its general adoption
demanded a much greater increase of engine revolution than
constructors in the early days, or for some years after, deemed it
prudent to adopt. Thus a great variety of design, including beam,
steeple, oscillating, and other forms of machines were used, all with
gearing between the engine and the propeller. But a few direct-
acting engines appeared very early, and gradually, as engineers
gained confidence, the latter type became universal, and assumed
the form of the inverted cylinder in the so-called steam-hammer
engine which was the universal type for mercantile purposes until
the end of the century.
“John Elder we may look upon as the father of multiple-expansion
engines. He, together with his partner Charles Randolph, was trained
in the marine school of Mr. Robert Napier, Vulcan Foundry, Glasgow.
In 1852 they commenced business, and by 1856 had constructed
several four-cylinder compound engines. Randolph, Elder and Co.
entered into a contract for a set of engines, the coal for which, on
trial, would not exceed 3 lb. per indicated horse-power per hour. The
trial ... worked out at 2¹⁹⁄₂₀ lb.” In regard to coal consumption, the
Pacific Steam Navigation Company’s boats Callao, Lima, and Bogota,
after being brought home from the Pacific coast to be re-engined, all
showed a consumption of from 2 to 2¹⁄₂ lb. (per indicated horse-
power) of best Welsh coal. The Bogota’s speed with the old engines
was 9·75 knots and the coal consumption not less than 38 cwts. per
hour. On her outward voyage with new engines she “gave a mean
speed of 10·47 knots with 19 cwts. of coal per hour.” The steam-
pressure was 22 lb. and the horse-power was about 950 indicated.
“These early fathers seemed to see into the future. Walter N.
Neilson, in his Presidential Address (1859), refers to the ‘three grand
requirements (of marine engines) as—a safe and suitable boiler for
100 lb. and upwards; a good arrangement of engine to receive the
initial force of the steam without shock or liability to derangement,
and carry out expansion to the greatest practical limits; and, lastly,
an efficient surface condenser.
“John Elder was among the first to adopt the surface condenser
and the cylindrical boiler, and he thus in the ’fifties brought to a
successful issue these three grand requirements. We must go back
to these early days to realise what it meant to make a boiler which
would be safe for 100 lb.; steel plates of the present day weighing
tons were then represented by puddled iron plates weighing
hundredweights. This led John Elder to try a water-tube boiler,
practically the modern Yarrow boiler, also a spiral tube boiler, but
probably none of these was successful owing to the salt-water
difficulty, evaporators not being introduced till many years
afterwards.”
As the adaptability of iron for constructional purposes became
more generally recognised, it led to the proposal that steamers
should be built on the longitudinal principle instead of with an
ordinary keel and a series of transverse ribs. The use of iron also
enabled shipbuilders to increase the safety of their vessels
considerably by means of transverse bulkheads, the number of these
being increased until, even as early as 1838, the iron steamers then
being built for the Glasgow and Liverpool line were each divided into
five sections, any three of which were estimated to be sufficient to
keep the steamer afloat if the other two should become waterlogged
through collision. Several vessels were constructed on modifications
of the longitudinal system, the chief among them being the Great
Eastern. In 1853 James Hodgson of Liverpool issued a circular on
the advantages of iron sailing ships, in which he pointed out not only
the greater strength obtained by using iron but the comparative
cheapness of construction. The circular stated that a wooden ship of
1000 tons would cost £16 10s. per ton, and an iron ship £13 10s.
per ton, both fitted for trade to the East. The wooden ship would not
carry more than 1500 tons, whereas an iron ship built from the same
external lines would carry 1800 tons, and this difference at £5 per
ton out and home, added to allowances for insurance, depreciation,
and interest, would make a difference in favour of the iron ship of
£2295.

The “Sarah Sands,” 1846.

 What was true of sailing ships was equally true of steamers, and
Hodgson had shown this some years before the publication of his
circular, when he built the Sarah Sands.
The Sarah Sands afforded an excellent example of the strength of
iron ships if well and substantially built. She grounded on the
Woodside Bank in the Mersey when carrying 1000 tons dead weight,
and remained high and dry until the tide flowed again, during which
time she did not sustain the slightest damage. She experienced
several mishaps at one time and another, which demonstrated not
only the superior manner in which she was put together, but also the
superiority of iron ships over wooden ones, for it is difficult to
suppose that a wooden vessel would have withstood all these
casualties without sustaining serious damage. The Sarah Sands was
built in 1846 at Liverpool; she was 182 feet between perpendiculars,
33 feet beam, 32 feet deep, and of 1400 gross tonnage. Her engines
were of 300 indicated horse-power and were built by Messrs. Bury,
Curtice, and Kennedy of Liverpool. She had two oscillating cylinders
of 50 inches diameter and a stroke of 3 feet, working upwards to the
crank shaft, and a still greater novelty was the application of a direct
coupling between the crank shaft and the screw shaft. Her boilers
were of the wet-bottomed type, and had six furnaces besides return
tubes, the steam pressure being 9 lb. She was four-masted and
heavily canvassed, carrying courses, topsails, and topgallant sails on
the main and mizzen masts, while she was fore and aft rigged,
including topsails, on the fore and jigger masts; her head sails
included a large fore staysail and two immense jibs.
She made her first voyage from Liverpool to New York in January
1847, in connection with the Red Cross Line, and remained in this
service until the end of 1849, when she was transferred to the
American coastal route between Panama and San Francisco, being
probably the first iron screw vessel to go round South America. The
discovery of gold in Australia caused her to be sent to Sydney with a
crowded passenger list of gold-seekers, and she was thus the first
iron screw steamer to cross the Pacific to Australia; she afterwards
came back to Liverpool and was again placed on the New York trade,
and in 1854 was sent to Canada and was the first iron screw
steamer in that trade also. On her return passage she struck the
rocks in the St. Lawrence, near Belle Isle, and remained fast four
days and nights. When she returned to Liverpool it was found that
she had not started so much as a rivet, which says a good deal for
the strength of her construction. This was destined to have another
unnecessary proof, for as she left the graving dock she capsized
owing to her ballast having been removed and not replaced, but
again she was none the worse. Next she was employed as a
transport for troops to India in 1857, and caught fire in her saloon,
but as the hull was of iron the fire was subdued and she put into
Mauritius with the whole after-part burnt out. This ended her career
as a steamer, for she returned to England under sail and was
converted into a sailing ship, and in the following year met with a
disaster which even her tough frame could not withstand; she struck
on the rocks near Bombay and went to pieces.
In 1850 several boats were designed for mail service in any
weather for a run not exceeding sixty miles and on which sleeping
accommodation was not required. One of the best of the type was
Her Majesty, built and engined by Robinson and Russell in 1850 for
the Portsmouth and Ryde station. She was an iron paddle-steamer.
The engines had two oscillating cylinders 27 inches in diameter with
30 inches stroke, and made 58 revolutions per minute. Her tubular
boiler, 9·75 feet long, 11·25 feet wide, and 6 feet high, developed
steam at 20 lb. pressure. The heating surface was 1234 square feet.
Engines, boilers, and water weighed 30·5 tons. The paddles were
11·16 feet in diameter and each had nine fixed floats. There were
three masts and the sail area was 64 square yards. Her speed was
12·8 knots; displacement, 93 tons; length, 127 feet; extreme beam,
26 feet.
The steamer Crœsus, for the Australian trade, launched at Mare’s
yard, Blackwall, in June 1853, for the General Screw Shipping
Company, was the largest vessel yet built for the firm. She was of
2500 tons, with engines by Messrs. G. and J. Rennie, of 400 horse-
power.
Messrs. Maudslay, like Messrs. Penn and other eminent engineers,
had been in the habit of having the ships for which they contracted
built by other firms, while they themselves supplied the engines.
They decided to do their own shipbuilding, and accordingly opened a
yard at East Greenwich. The first vessel launched there was the Lady
Derby, of 530 tons gross, built for the General Iron Screw-Collier
Company.
Those were the days when Thames shipbuilding was at its zenith.
While trade was good, freights high, and shipowning was profitable,
shipowners did not mind paying high prices for their vessels; but as
the north-east coast, the Mersey, and the east and west coasts of
Scotland developed their iron shipbuilding facilities, and by reason of
their proximity to the coal and iron fields were able to obtain these
commodities at lower prices than the Thames shipbuilders could
secure them, they were able to underbid the Thames shipbuilders
and secure the industry, with the result that there is now but one
shipbuilding establishment of importance in the Thames equipped to
turn out a large warship or liner. Its competitors and neighbours of
half a century ago vanished one after another. Some have passed
out of existence, others have become merely repairing yards, and
two or three have gone elsewhere and prospered. The one survivor
is the Thames Iron Works and Shipbuilding Company, which, on the
site made historic by Mr. Penn’s enterprise, proudly endeavours to
hold its own and maintain the traditions of the river.
Mare’s shipbuilding yards on the shores of Bow Creek, near its
entrance to the Thames, started in a very small way, but within
seventeen years it extended until it was employing nearly 400
hands. In 1845, a large portion of the Essex side of the yard was a
marsh, covered with water at high tide. By 1854 it was one of the
principal shipbuilding yards in the world. The wages of the workmen
at Blackwall averaged for eighteen months £5000 per week, and
some weeks it was £1600 more. The yards of Messrs. Green, Messrs.
Scott Russell, Messrs. Dudgeon, Messrs. Maudslay, Messrs. Samuda,
Messrs. Yarrow, and Messrs. Thorneycroft, to mention only a few,
besides a host of smaller builders, employed their thousands of
hands; but never a keel is laid there now. The banks of the river
which rang to the stroke of the shipwrights’ hammers are silent; the
slips are unoccupied or devoted to other uses, the furnaces are cold;
the machinery is sold or dismantled, and fragments of it may yet be
seen rusting ingloriously on the scrap-heap. Dawn now brings no
activity to the shipbuilding yards of the Thames, and dusk adds
nothing to their stagnation. Steam-ship repairing work is nearly all
that London river sees now. If, as sailors say, ships have spirits that
return to the yards where the vessels were built, when those ships
are lost or broken up, there must be many homeless phantoms
haunting the banks of the historic stream, seeking rest and finding
none, and perchance, as did certain of the ships they represent,
going down the river with the tide never to return: a ghostly fleet
bearing many mysteries which shall not be solved till the day when
the insatiable sea is called upon to surrender all it has taken captive.
The general superiority of iron screw steamers over those of wood
led to the introduction of a number of types designed to meet the
requirements of special trades.
James Hodgson, who, in addition to the Sarah Sands, built the
Antelope, the first iron screw steamer to leave Liverpool for the
Brazils, introduced the tubular type of iron vessels. The Carbon, a
vessel of this type, was built by him for the Eastern Archipelago
Company in 1855. In the construction of this boat he proposed to
dispense with the ordinary side frames altogether.
He stated in his synopsis that calculations of the strength of thirty
frames, in a ship that had answered exceedingly well, showed that a
partial bulkhead or frame projected from the side of the vessel to
the extent of only 20 inches was more than equal in strength to the
thirty frames, if it were supported on two bearings at a given
distance and weighted on the upper side in the middle. This frame,
of 20 inches deep, would carry more than the whole of the thirty
frames, and when the bulkhead was extended across to the other
side of the ship there would be a great preponderance of strength in
favour of the bulkhead. But, in dispensing with frames, it might, in
some cases, be necessary to increase the plating for the sides, to
give some additional strength. Since the strength of the materials
increased as the square of the thickness, the addition of one-eighth
to five-eighths of an inch plate increased the strength to resist a
blow sideways, or in a lateral direction, by nearly 50 per cent. The
strength of the vessel was further increased by placing the bulkhead
in the widest part of the ship, amidships, and by other bulkheads
placed midway between the midship bulkhead and the bow and
stern, should it be deemed advisable; and also by the interposition
of stiffening plates. Other strengthening means were also
recommended. The vessel would be, he contended, “capable of
sustaining a considerable pressure, either externally or internally,
having round, swelling, or convex sides, with a ridge or rib on the
lower side which answers the purpose of a keel.”
Vessels of this type were expected to be much more economical to
build, and no more expensive to run than those built on the ordinary
lines. It was disputed whether a tubular vessel being without frames,
floors, &c., would be strong enough for all purposes. An accident to
Mr. Hodgson’s tubular cargo vessel, The Carbon, however, seemed to
justify his contentions, for she stranded badly when being launched,
so that her stern was submerged at high water. She was towed up
the slip again, and refloated, and it was found that only two plates
required repairs. The Carbon was running until quite recent years in
the east coast coal trade to London.
Another important development in construction was due to Mr. J.
Scott Russell, who has been described, like Sir I. K. Brunel, as a man
before his time. Mr. Russell’s services to steam navigation in his
exposition of the wave-line theory of ship construction were of
incalculable benefit to the science. His object was to diminish the
resistance offered by the water to the passage of the ship, and the
modifications he made in the lines of the hull not only effected this
to a very remarkable degree, but also increased the seaworthiness
and speed of the vessels. He designed a number of small vessels
suitable for special trades or to meet particular requirements.
One introduced about 1855, for North Sea work, was an iron
screw steamer with a long parallel middle body which made a
capacious ship, the fore and after parts being designed in
accordance with his wave-line theory. Another of his cargo vessels,
having a greater length of parallel middle body and wave-line ends,
had the screw propeller abaft the rudder, which was entirely below
the propeller shaft, there being a loop in the rudder stock through
which the propeller shaft passed. A second vessel of this type, but
rather longer in proportion to its beam, was designed for the Baltic
trade, and had the peculiarity that its forecastle extended as far as
the midship deck-house.

The “City of Glasgow” (Inman Line, 1850).

The period from 1845 to 1880 is remarkable for the progress

made in steam-ship building prior to the general adoption of steel for
the construction of ocean vessels.
The early history of the Cunard Line has already been related.
Before the last wooden Cunarders were built, the Inman Line
appeared on the scene with a service of iron steamers with screw
propellers, the first being the City of Glasgow, launched in 1850 by
Tod and McGregor on the Clyde, for a transatlantic service they
themselves intended to establish with Glasgow as its headquarters.
The side-lever engine of the ordinary type was modified for this
vessel, as it was fitted with two beams working across the ship. The
cylinders were on one side of the ship, and on the other was a large
wheel which geared three to one with ordinary teeth into the
propeller-shaft pinion. Her machinery was placed low down in the
hold so as to leave her decks as free of encumbrances as possible.
She was a three-decked vessel of 1069 tons gross, 227 feet long
by 33 feet beam and 25 feet depth; and her engines of 350 horse-
power drove a two-bladed screw of 13 feet in diameter and 18 feet
pitch. She was designed to carry 52 passengers in the first class; 85
in the second class, and 400 in the steerage, and a crew of about
70. The hull was divided by five water-tight bulkheads into six
compartments, and as a further provision for the safety of her
passengers and crew she carried six lifeboats. Her fresh-water tanks
contained no less than 13,000 gallons. She was barque-rigged, of
almost yacht-like lines, and had a graceful clipper bow. The City of
Glasgow made a few voyages between Glasgow and New York in the
spring and summer of 1850.
Mr. William Inman of Liverpool had meanwhile been preparing for
the establishment of a line of steamers between Liverpool and
America. His idea was that modern iron vessels, equipped with screw
propellers, were bound to supersede paddle-wheel vessels, and also
that there was money to be made in the emigrant trade. His decision
to place fast steamers in this trade, however, was as much
philanthropic as commercial, for he was profoundly moved by the
reports of the sufferings and inconveniences experienced by
emigrants in sailing ships, no less than by the accounts of the fearful
mortality among them. The carrying of emigrants was, at that time,
confined to sailing ships, many of which were wholly unsuited to the
purpose. The steamer companies catered chiefly for those who could
afford to pay well. Mr. Inman determined to cater for the emigrant
traffic also, and for forty-two years the line bearing his name was
pre-eminent in this branch of the work of the Atlantic ferry.
Practically the only steamer which met the requirements he had in
mind was the City of Glasgow, and in the autumn of 1850 she was
acquired by the founders of the Inman Line.
“It was on December 10, 1850, that the Liverpool and Philadelphia
Steamship Company was established. Their agents were Messrs.
Richardson Bros. and Co., who had already a number of packet ships
of their own. They were the chief owners of the City of Glasgow, and
their junior partner was Mr. William Inman, who managed the
shipping department of the business.” This extract from the “Official
Guide” of the Inman and International Steamship Company Ltd.,
published about 1888, is of interest in view of the various accounts
of the inception of the company which have been made public. The
first sailing of the City of Glasgow for her new owners took place on
December 17, 1850, from Liverpool for Philadelphia. She was under
the command of Captain Matthews, who formerly had charge of the
Great Western.
In June 1851, the City of Manchester, by the same builders and
also of iron, was purchased by the Inman organisation. She was of
2125 tons and carried “overhead” or “steeple” geared engines of 350
horse-power. Her cylinders and proportion of gearing, however, were
identical with those of the City of Glasgow.
In October 1851 the City of Pittsburg was built at Philadelphia and
was the first American-built screw-propelled steamer in the North
Atlantic service. The City of Philadelphia was delivered by Messrs.
Tod and McGregor in 1853, being of slightly greater tonnage than
her predecessor from the yard; but she was eclipsed by the City of
Baltimore ordered the same year, the dimensions of the last named
being: 326 feet in length, 39 feet breadth, 26 feet depth, 2472 tons
gross and 1774 net.
This vessel took the place of the City of Glasgow, which in March
1854 disappeared in mid-ocean with 480 souls on board. In
September of the same year the City of Philadelphia was wrecked off
Cape Race, but there was no loss of life.
“Inman’s iron screws,” as they were dubbed, were attracting
attention, and it was recognised as merely a question of time when
steamers of this type would prove successful rivals to the paddle-
boats.
Mr. Inman became sole managing director in October 1854, as the
result of the offer of the British Government to charter certain of the
steamers as transports during the Crimean War, the use of the
vessels for this purpose being disapproved by Messrs. Richardson,
who were Quakers. About this time the company purchased the
Kangaroo from the Pacific and Australasian Company, and ordered
the City of Washington from Messrs. Tod and McGregor. The
Kangaroo was 257 feet in length, 36 feet in breadth, 27 feet depth,
and had a gross tonnage of 1719 tons. The City of Washington was
358 feet in length, 40 feet in breadth, and 26 feet depth, with a
gross tonnage of 2870 tons.
The Crimean War saw a great demand by the Allies for transports,
and as the French Government offered better terms than the British
Government, the City of Manchester was chartered to the French,
and was followed by the City of Baltimore, and six months later,
when she had concluded her trial trips, by the City of Washington.
Upon the termination of their engagement as transports these
vessels returned to the Liverpool and Philadelphia service.
For some time Mr. Inman had been considering the advisability of
making New York his American port instead of Philadelphia, and
when the Kangaroo, with all her passengers on board, was frozen up
in the Delaware and her departure for Liverpool was delayed for five
weeks, he inaugurated, in December 1856, a monthly service to New
York with the City of Washington. Two months later the Inman
sailings were increased to fortnightly, the sailings in the alternate
weeks being undertaken by the Collins liners. This arrangement was
very short-lived, for in the same month the Collins Line service was
withdrawn. In 1857 also, the title of the organisation was changed to
“The Liverpool, New York, and Philadelphia Steamship Company,” to
mark the extension of the service to New York.
In October 1857 Mr. Inman’s Company bought up the Glasgow
and New York Steamship Company, and placed two of the vessels,
the Edinburgh and the Glasgow, in the trade between Liverpool and
New York. By 1860 the demands upon the resources of the line were
such that the first City of New York was ordered from Tod and
McGregor. She was 336 feet in length, by 40 feet beam, and 28 feet
depth, and was of 2360 tons gross. Her engines were of the
horizontal, trunk type, and she was the first vessel of this line in
which engines of this design were installed.
The rivalry between the Inman and Cunard Lines was intense, and
neither company produced a steamer which the other did not seek
to surpass, but the Inman Company forged ahead both in the matter
of speed and passenger accommodation and became for a time the
premier company on the Atlantic. The White Star Line, however,
entered the “ferry” with vessels of a different type, and the
competition between the three great companies became keener than
ever. The first City of Paris was added to the fleet in 1866. Her
Cunard rival was the Russia. The City of Brussels, of 3081 tons,
began her sailings in October 1869. She was the last of the Inman
Line to be fitted with the long wooden deck-house which was a
conspicuous feature of so many ocean-going steamers. Her average
speed was between 14 and 15 knots, which was slightly increased
when she was re-engined in a few years’ time. In December 1869
she made the voyage from New York to Queenstown in 7 days 20
hours 33 minutes, a record which remained unbeaten until
September 1875, when the City of Berlin made the westward
passage in 7 days 18 hours and 2 minutes, and the homeward run in
7 days 15 hours 48 minutes. The City of Brussels was the first
vessel, apart from the Great Eastern, in the North Atlantic trade, in
which McFarlane Gray’s steam-steering gear was introduced.
The dangers inseparable from the North Atlantic traffic led to the
adoption by the company in 1870 of the “lanes” or routes across the
ocean as suggested by Lieut. Maury of the United States Navy, a
more southerly course being taken during the months from January
to August, to avoid the icebergs from the northern regions. The
Cunard and other steam-ship companies adopted the system about
the same time.
The City of Berlin was contracted for by Messrs. Caird and Co. in
1873, and when she was launched the Inman fleet counted up
thirty-one vessels with a total of 76,766 tons. The rivalry between
the builders of the great ocean-going liners, no less than between
the firms owning the ships and the officers of the ships themselves,
was very great, and Messrs. Caird were successful in their endeavour
to turn out a vessel which should be admitted to be the finest
ocean-going steamer afloat. The rapid acquisition of one first-class
vessel after another placed the Inman Company in the front rank.
This steamer was 489 feet long on the keel, and 513 feet over all, by
45 feet beam and 36 feet depth. Her speed was about 16 knots. She
was of 5491 tons gross and 3139 tons net. She had a pair of engines
of the inverted direct-acting compound type, with high- and low-
pressure cylinders, and of 1000 nominal horse-power, but on her
trial trip the indicated horse-power was 5200, and this was
sometimes exceeded in her voyages. Her low-pressure cylinder was
120 inches in diameter, and the high-pressure was 72 inches. Her
twelve boilers were heated by thirty-six furnaces, the boilers being
so arranged that any number of them could be cut off.
It was pointed out by the Nautical Times that while the nominal
horse-power of the City of Bristol, added to the fleet in 1860, was as
one to ten as regards the gross tonnage, that of the splendid City of
Berlin, put on the line in March 1875, was as one to five and a half.
She could accommodate 400 passengers, of whom 200 were in the
saloon, 100 in the second cabin, and the remainder in the steerage,
and her crew numbered 150. Electricity as a means of lighting was
introduced into the transatlantic trade on this steamer in November
1879.
All the Inman vessels hitherto launched were ship-rigged, and all
had the graceful clipper bows for which the line was famous, the
Inman fleet being unequalled for beauty. At times, as they were
overhauled, they were barque-rigged, and one or two were given a
three-masted schooner rig.
 The “City of Rome” (Inman Line, 1881).

In June 1881 the beautiful City of Rome was launched at Barrow

for the company, and sailed on her maiden voyage in the following
October. She was constructed of iron throughout, and was 560 feet
in length by 52¹⁄₂ beam and 37 feet depth, and was of 8144 tons
gross. This was the first of the company’s steamers to have three
funnels, and being placed between the main and mizzen masts at
regular spaces they served to add to the appearance of the vessel.
Her machinery marked another important innovation as, although
the engine was on the three-crank system, it had three high-
pressure cylinders of 46 inches diameter each, and three low-
pressure cylinders of 86 inches diameter each, arranged on the
tandem method, and the piston had a stroke of six feet. The eight
boilers worked up to 90 lb. pressure, with forty-eight furnaces so
arranged that a water-tight bulkhead was fitted fore and aft and
formed the coal bunkers, but this arrangement was modified
afterwards. This splendid vessel did not come up to expectations in
the matter of speed and was returned to the builders.
 In 1875 the company was converted into the Inman Steamship
Company, Ltd. The City of Rome was the last steamer the founder of
the line ordered, and he died before her completion. No further
additions were made to the fleet of the Inman Company. After the
company and fleet were acquired by the International Navigation
Company in 1886, the new firm also bought the City of Chicago
while she was on the stocks for the Dominion Line. This vessel was
the only one under the Inman flag to have a straight stem. She ran
for several years, and was then lost on the south coast of Ireland.

The “City of Chicago.”

 The “Persia” and “Scotia” (Cunard, 1856 and 1862).

The first iron steamer built by the Cunard Company was the
Persia, and she deserves more than a passing mention because of
the association with her of David Kirkaldy, Napier’s draughtsman, to
whom modern steel shipbuilding owes the discovery of the way to
toughen steel and remove its brittleness. Kirkaldy’s drawings of the
Persia are stated to have been the only steam-ship designs ever
exhibited at the Royal Academy. He was also the first on the Clyde to
give the question of trial performances the attention it deserved. The
first trial trips recorded by him, on the Larriston, on September 22
and October 18, 1852, were printed when the Admiralty asked for
particulars of the respective behaviour of a Smith’s and a Griffith’s
propeller. But he was not allowed to continue his researches in this
direction, and even the Persia left the Clyde without a single diagram
having been taken, for although Kirkaldy was in the engine-room
during the entire trial, he had not permission to record her
performances. He obtained data concerning many vessels “so as to
be able to deduce the variations of behaviour and relative economy,
and trace such to their respective origins, e.g., whether any variation
was due wholly or in part to the difference in the shape of the
vessels, in the propellers, in the engines, or in the boilers. The utility
of these investigations was signally demonstrated in the case of two
vessels, Lady Eglinton and Malvina ... the former proved a great
success on her trial trip, and the latter a comparative failure. He was
able to trace the cause of the failure and in great measure to rectify
it. He clearly foresaw that the time was surely approaching when his
employers would require to estimate for and construct vessels to
fixed requirements as to draught, speed, and economy of
working.”[87]
[87] “Illustrations of David Kirkaldy’s System of Mechanical
Testing,” by Wm. G. Kirkaldy.

The drawings of the Persia were made for his own pleasure, and
the first intimation of their existence was the announcement in the
papers that they had been admitted to the Academy. By Napier’s
instructions they were exhibited at the Paris Exhibition of 1855
together with drawings of the steam-ships Europa, America, Niagara,
and Canada. Napier received a gold medal and the Legion of Honour
as exhibitor, and Kirkaldy received a medal as draughtsman. The
drawings of these four ships were placed in the Louvre Museum
after being presented to the Emperor Napoleon.
The Scotia, the second and last of the Cunard iron paddle-
steamers, followed in 1862. She was 379 feet in length, of slightly
greater beam and depth than the Persia, and of 3671 tons, and her
engines of 4900 indicated horse-power gave her a speed of nearly
14¹⁄₂ knots. The Persia was sold in 1868, and was converted into a
sailing ship. The Scotia was kept in the service as long as possible,
as she was a favourite with the public, but her very limited cargo
space and her immense consumption of coal made it impossible to
run her except at considerable loss. She was consequently
withdrawn in 1875, and sold to the Telegraph Construction and
Maintenance company, which had her re-engined and turned into a
twin-screw boat. She remained in the service of this company for
many years, and was used for cable-laying purposes. These were
not, however, the Cunard Company’s first iron steamers, as they had
already had for some time two smaller vessels of iron in their
Liverpool and Continental service.
By this time the Cunard directors were convinced, by the success
of the Inman steamers, and by the advice of the engineers whom
they consulted, that the paddle-steamer had reached its utmost
point of development. Henceforth they built screw steamers, the first
being the China, launched in 1862, and followed by the Java in
1865, and the Russia in 1867.

The “China” (Cunard, 1862).

 The “Russia” (Cunard, 1867).

The Russia, and the Inman steamer City of Paris, the finest
commercial vessels afloat, left New York on the same day in
February 1869, within about an hour of each other and arrived at
Liverpool with only thirty-five minutes difference between them.
They made the run across the Atlantic, with the twenty minutes’
stop at Queenstown, in about eight days, eighteen hours. The City
of Paris started first, and got in at 3.45 a.m., and the Russia at 4.20.
The vessels were in company for four days. Once the Russia passed
the City of Paris, but the Inman liner took the lead again, and at
another part of the voyage the Cunarder recovered her lost ground.
As racing, however, was strictly forbidden by the rules of the two
companies, and the ships’ logs showed that no extra pressure of
steam was used, it is supposed that in this, as in many other cases
of supposed ocean racing, the race existed mainly in the imagination
of the passengers, who for lack of anything else to do worked
themselves up into a frenzy of excitement about it. The captains, of
course, merely concerned themselves with putting in all the
seamanship they knew. Pictures published at the time show that
both vessels were under full sail, and even carried stunsails.
The China, after some years’ service, was sold and converted into
the sailing ship Theodor, and proved as fast after the change as
when a steamer. She foundered at sea in 1908.
In 1866 another competitor appeared on the North Atlantic. The
fate of the Collins and Galway Lines did not deter Mr. S. B. Guion
from inaugurating a rival service to that maintained by the Cunard
and Inman Lines, and for a time it seemed as if he would be
successful in wresting from the splendid vessels of these companies
the premier position on the Atlantic. The steamships which he placed
on the service between Liverpool and New York were at that period
superior in size, speed, and luxury to any of their competitors. He
started the service with the Manhattan, and thus inaugurated in
1866 what may be called the great race of the greyhounds of the
Atlantic. The Manhattan was built by the Palmer Company of
Newcastle-on-Tyne, and was the first of seven steamers comprising
the line. Her length was 343 feet, her beam 42 feet 6 inches, and
her depth 28 feet, and her register was 2866 tons. She had
accommodation for 72 passengers in the first class, and 800 in the
second class, and besides taking 1000 tons of coal could carry 1500
tons of cargo. A feature of this vessel was the attention paid to the
comfort of the second-class passengers, the cabins for this class
being on the main deck and thoroughly ventilated, wherein they
showed a marked improvement on the many other vessels carrying
emigrants. She was fitted with low-pressure inverted direct-acting
surface condensing engines, designed by Messrs. J. Jordan and Co.
These had cylinders of 60 inches in diameter, with a piston stroke of
42 inches. The Chicago and the Merrimac, sister ships, followed from
the same builders. The Chicago was wrecked in a fog on the rocks
near the entrance to Cork Harbour, and, a contrast to some of the
disasters to Atlantic liners, not a life was lost, the whole of the
passengers and crew, numbering 130, being landed by the ship’s
boats within an hour of the accident. The earlier Guion liners were
brig-rigged steamers, and some of them carried the new American
double topsails on both masts. Other boats which formed a part of
the earlier fleet of the Guion Line were the Nebraska, Minnesota,
Colorado, Idaho, and Nevada. In 1870 these were augmented by the
Wyoming and Wisconsin, also built and engined by Messrs. Palmer.
These were each 366 feet long, 43 feet broad, 34 feet deep, and of
3238 tons register. Among other distinctive features they had the
first compound engines on the transatlantic route. These had one
vertical high-pressure cylinder of 60 inches in diameter, and one
double-trunk horizontal low-pressure cylinder of 120 inches in
diameter, both working on the same crank, and having a stroke of
42 inches. Great expectations as to speed were entertained when
the Montana and Dakota, from the Palmer yards, were brought into
the service in 1872. They exhibited a new design in hull and
machinery as they had an abnormal slope of side, flush steel plating,
and water-tube boilers. These vessels each had a length of a little
over 400 feet, with a breadth of 43³⁄₄ feet and a depth of 40³⁄₄
feet. Like the Wyoming and Wisconsin, they had compound engines,
one high-pressure cylinder of 60 inches diameter, working inverted
on a forward crank, and two low-pressure cylinders working
horizontally on the after crank. The Montana’s boilers were
constructed of a series of cross-tubes 15 inches in diameter and
were intended to carry a head of 100 lb. of steam, but in
consequence of an explosion when at 70 lb. pressure, they were
replaced by ordinary tubular boilers with a pressure of 80 lb. of
steam. The Dakota was wrecked on the Welsh coast in May 1877,
and a similar fate befell the Montana three years later. Seven years
passed and then the Arizona was brought into the Guion service.
She was of iron and was built and engined by Messrs. John Elder
and Co. of Glasgow. Her dimensions were: 450 feet long, 45¹⁄₈ feet
broad, 35³⁄₄ feet deep, with a register of 5147 tons. She differed
from the earlier boats of the line by being four-masted, carrying
square sails on the fore and main masts, having two funnels, and
having her saloon accommodation amidships; in all these particulars,
as well as in the straight cutwater, she bore a strong resemblance to
her rivals of the White Star Line.
 Model of the “City of Paris,” 1866.

Although there was no deviation in her hull from the existing type,
her machinery displayed some novel features. Her engines were
compound with three crank shafts, each having one cylinder. The
high-pressure cylinder was 62 inches in diameter, and was placed in
the centre, between the low-pressure cylinders each of 90 inches,
and all had a piston stroke of 66 inches. Steam was generated in
seven boilers capable of withstanding 90 lb. pressure, and furnished
with thirty-nine furnaces, which had an average coal consumption of
125 tons per day, or in round figures 25 per cent. in excess of her
fastest rivals, which were then in the White Star Line. On her
homeward voyage from New York in July 1879, the Arizona
succeeded in breaking the record, and repeated the feat on her
outward passage in May 1880, when she made the passage from
Queenstown to New York in 7 days, 10 hours, 47 minutes, thus
proving herself for two years in succession the fastest boat on the
Atlantic. While on her homeward passage in November 1879, the
Arizona collided at full speed with an iceberg. Although she gave the
berg a direct blow she is one of the few vessels that have managed
to survive after such an experience. It was stated at the time that
there was a projecting spur of ice from the berg under water, and on
this the ship slid. Her weight caused the berg to rock, and it was to
this circumstance alone that she owed her safety, for the rocking of
the huge mass of ice enabled her to slip off the spur into deep water
again. A tremendous quantity of ice, dislodged by the shock, crashed
down upon her deck, doing a considerable amount of damage, and
she had only drifted a few hundred yards from the berg, after the
impact, when an immense portion of it fell at the spot where only a
few moments previously the ship had rested. This is one of the
narrowest escapes recorded in the annals of the sea. Fortunately,
her collision bulkhead withstood the enormous strain, and the vessel
received a magnificent, though entirely undesired, testimonial to the
soundness and stability of her construction. She put into St. John’s,
Newfoundland, and was found to be so badly damaged that she had
to have entirely new bows. The success of the Arizona led to the
building of the Alaska, which proved another triumph for Messrs.
John Elder and Co., for the speed she developed won her the title of
the Atlantic Greyhound, her homeward passage in June 1882 being
less than seven days. This remarkable run was, however, eclipsed by
the Oregon, the last vessel added by the Guion Company prior to its
dissolution; she sailed from Liverpool to New York on October 6,
1883, and accomplished the passage from Queensland to Sandy
Hook in 6 days 10 hours 9 minutes. The Oregon was an iron vessel
built and engined by Messrs. John Elder and Co., on similar lines to,
but of greater dimensions than, the Arizona and the Alaska. She was
no less than 500 feet in length, 54 feet wide, 40 feet deep, and
registered 7375 tons. Her engines were compound and consisted of
one 70-inch high-pressure cylinder placed in the centre, and two
low-pressure 104-inch cylinders, with a 6-foot stroke; her boilers had
a steam-pressure of 110 lb., and her average daily consumption of
coal was 310 tons.
 The “Oregon” (Cunard and Guion Lines, 1883).

From about this time the passenger service across the Atlantic
began to assume proportions and a degree of importance to which it
had never before attained. Hitherto the steamers engaged on the
transatlantic route had depended considerably on their cargo
capacity as a means of meeting expenses, but with the demand for
larger and faster vessels—and faster vessels could only be made
larger—there was developed an express passenger boat which
depended almost wholly on its passenger accommodation and
carried a much smaller amount of cargo than some of the older and
smaller vessels then engaged in the trade. The Guion Line did not
wholly meet these requirements, and on the death of Mr. S. B.
Guion, the line gradually dropped out of existence, the remaining
vessels of the famous fleet of steamers being dispersed in various
directions. Some years before this happened, however, the White
Star Line began to build steamers for the Atlantic.
The White Star Line has always been the line of big ships. In its
sailing-ship days it owned some of the finest wooden clippers afloat,
famous alike for their size and speed. When Mr. T. H. Ismay in 1867
took over the management of the line and formed with some friends
the Oceanic Steam Navigation Company, there were already in
existence the Cunard, Inman, Guion, and National Lines, which had
secured such control of the Atlantic trade that it seemed almost
rashness for the new line to venture to compete with them. “Nothing
venture, nothing win”; the line now holds a position second to none
in the world for the magnificence and size of its steamers. All its
vessels have been built by Messrs. Harland and Wolff at Belfast. The
first of the fleet was the Oceanic, launched on August 27, 1870,
which started on her maiden voyage and the inaugural voyage of the
fleet on March 2, 1871. Several vessels of the same type followed in
rapid succession, all having the straight stem, four masts, and single
funnel which were the distinguishing marks of the White Star
steamers in those days. The Oceanic was 420 feet long, 41 feet
beam, 31 feet deep, and had a registered tonnage of 3707. These
steamers were somewhat differently designed from the other boats
on the North Atlantic. The high bulwarks and narrow wooden deck-
houses were dispensed with, and instead another iron deck was
added with open iron railings round it, there being thus nothing to
hold any water that might come on board. The saloons were
amidships and extended the entire width of the vessel, and the
staterooms were placed before and after the saloon and were better
lighted and ventilated than those of any other steamers. The
engines also were of a novel type; they were compound, four-
cylindered, and arranged tandem, with two high-pressure cylinders
each 41 inches diameter and two low-pressure each 78 inches in
diameter, working on two cranks and having a stroke of five feet.
The engines were arranged fore and aft, and each formed a
complete engine in itself, so that either could be worked in case of
accident to the other. The Oceanic inaugurated the era of the
modern type of express ocean liner. After a few voyages some
alterations were made in her, which added to her efficiency, her
masts being shortened, and a whaleback being built over her stern.
In 1875 she was transferred, together with her sisters the Belgic and
Gaelic, to the Pacific to inaugurate the White Star steam service
between Hong-Kong, Yokohama, and San Francisco.
 Two famous sister ships the White Star Line had were the
Germanic and Britannic, built in 1875 and 1874 respectively; they
were each 455 feet long, 45 feet broad, 33 feet 9 inches deep, and
of 5004 tons register. The hulls were built at Belfast, but the engines
were by Maudslay, Sons and Field and similar to those of the
Oceanic. With a speed rather above 16 knots, they were the first to
reduce the passage to below seven days. Numerous experiments
were made with a lifting propeller in the Britannic, but they were not
a success and the principle was never tried in any more of the
company’s boats. The company sought also to improve the lighting
of their steamers. The old system of lighting a ship by candles was
seldom more than enough to make the darkness visible, and oil
lamps were not always much better; so an attempt was made to
install a gas-lighting apparatus. It worked very well while the vessel
was in port, the experiment being made on the Adriatic in 1872, and
the Celtic in 1873; but there was a certain amount of leakage
through the working of the ship in a sea-way and the experiment
was abandoned. Oil lamps were then installed in these steamers and
remained in use until superseded by electric light. Another White
Star experiment was with the oscillating saloon, intended to keep
berths and staterooms level while the ship was rolling, but this was
no more a success on the broad Atlantic than it was on the English
Channel when tried in the steamer Bessemer.
Other lines which have played a conspicuous part in the North
Atlantic trade are the State, the Beaver, and the National Lines, all of
which owned some very fine steamers. The last named was founded
to run a line between Liverpool and the ports of the Confederate
States when the war should terminate, but it proved a financial
failure and the promoters then decided to enter the Liverpool and
New York trade. Its three vessels, Louisiana, Virginia, and
Pennsylvania, were the largest cargo-carriers on the ocean, being of
nearly 3500 tons gross. Three larger steamers, The Queen, Erin, and
Helvetia, were added in 1864, and three more in the next two years.
The Italy, of 4300 tons, was regarded as a wonderful ship on
account of her size, and is stated to have been the first of her type
in which compound engines were fitted. Other and larger steamers
were added to the fleet to meet its extensive requirements, until it
sustained not only a weekly service each way between Liverpool and
New York, but also had regular sailings from London to New York,
calling at Havre. Its steamers were not beautiful or fast, but were
very steady, made cargo-carrying a feature, and conveyed a great
number of emigrants. Then the National Line surprised every one by
bringing out in 1884 one of the most beautiful and graceful steamers
ever seen on the Atlantic, and certainly the fastest of her day—the
America, which, as she was built of steel, belongs properly to a later
period of ship construction. She was 5528 tons gross, built and
engined by Messrs. J. and G. Thomson, and was sold in a few
months to the Italian Government. Some years later the line began
to decline and it is now a part of the “Combine,” only two or three
vessels being under its flag.

The “America” (National Line, 1884).

The first mail steam-ship line between Liverpool and Canada was
started by McKean, McLarty, and Lamont of Liverpool in 1852 under
contract with the Government, but the effort was a failure, and in
the next year H. and A. Allan undertook the work. Their first steamer
was the Canadian in 1853, followed by the Indian, North American,
and Anglo-Saxon, and as the Grand Trunk Railway was completed
next year to Portland, this town became the winter terminus of the
line and Montreal the summer terminus. Upon the completion of the
intercolonial railway in 1876, connecting Quebec with Halifax, the
Nova Scotian port became the winter terminus of the Allan Line. By
1882 the service had increased to such an extent that the sailings
were made weekly instead of fortnightly. In 1862 the Allans
established a line between Glasgow and Montreal; a few years
afterwards sailings were made between London and Canada, and
more recently still Continental calls were added.
The Donaldson Line, established in 1855, has for many years
maintained a service between Glasgow and Montreal, its vessels
ranging from sailers to some of the finest steamers entering the St.
Lawrence River. Its present service is performed with the twin-screw
steamers Athenia and Cassandra, and nine single-screw boats; and
another twin-screw boat, the Saturnia, is shortly to be delivered, and
will be of about 8000 tons, the largest in the company’s fleet. The
salient feature of the Donaldson Line passenger steamers is the
carriage of one class of cabin passengers only, called second cabin.
This enables travellers to enjoy the best the ships afford, the
accommodation being equal to that on many long-distance
steamers, such as those that go to Australia. Its first steamer to
Montreal was the Astarte in 1874, upon the withdrawal of the line
from the South American trade in which it had been engaged up to
then; and its Canadian service, fortnightly at first, became weekly in
1880. A line to Baltimore, Maryland, was established in the winter of
1886-7, and the winter service to Canada began with the Baltimore
boats calling at Halifax on their west-bound voyages.
No further attempt was made by the Americans to establish a line
of steamers across the Atlantic until 1871, but in that year Messrs.
Cramp of Philadelphia received orders for four large steamers of over
3000 tons each, and these with some English vessels maintained the
service of the American Line. In 1884 the Red Star Line took over
the line and ran the boats as cargo steamers. They were again
transferred in 1893 to another American Line which three years later
sold them. In the meantime, the later American Line ordered a
number of vessels and, besides buying up the Inman Line, absorbed
the Inman and International, which owned the steamers City of Paris
and City of New York. The new owners dropped the words “City of,”
and also had two steamers built in America to comply with the Act of
Congress under which the line was formed.
The screw propeller was naturally not long in commending itself to
the builders of ships for the long voyages to India and Australia.
Mr. John Dudgeon, in an article published in 1856 on steam
expansion and the suitability of expansion engines for long voyages,
was almost prophetic in his remarks on the relative value of the
screw propeller and the paddle-wheel. In the article he said:
“The application of this property in steam to Australian screw
steam navigation, would, if adopted, effect a radical change in the
whole question. When we find that vessels of the magnitude of the
Great Britain have to run thousands of miles out of their course to
get a fresh supply of coal, it becomes a question whether that state
of matters may not be amended. I therefore propose that vessels of,
say, 2000 tons be built and fitted with engines working up to 1100
horses actual power, which would ... consume 1609·5 lb. of coal per
hour, and with this power the vessel would steam at least 10 knots
an hour ... equal to 19 tons 4 cwt. per day and a speed of 240
knots; 500 tons of coal would therefore be enough for a run of
twenty-five days, and 6000 nautical miles. Should it be deemed
prudent to carry a reserve stock, coal for an additional 1500 miles
would still not seriously interfere with the carrying properties of a
large vessel, while it would obviate the necessity of having any
stoppage but the Cape between Great Britain and Port Phillip. A
vessel of 2000 tons builders’ measurement will carry at least 2000
tons dead weight, over and above her own weight of ship and
machinery. Presuming that she takes coal for 9000 miles, or 750
tons, we still have a balance of 1250 tons for cargo and, in a well-
arranged vessel, room for 350 passengers. Now I apprehend that as
regularity and multiplied means of communication are the prime