This thesis outlines the findings of a large body of research work undertaken during 3 years of full-time study. The findings have already provided the author with helpful anchors for structuring formative feedback to surgical trainees within a simulation program, as well as helpful insights into her own learning. This thesis explores the operating theatre as a teaching and learning environment for postgraduate surgical trainees. The work crosses paradigms and uses contrasting methodologies to provide rich insights into surgical pedagogic practice. The first chapter is an introduction to the subject material, outlining the thesis aims and research questions, making clear why the research is important. The perspectives of the researcher are explained, in the first person, to make explicit her background and epistemological stance. The next chapter presents a narrative review of the literature, providing a background to the subject and a theoretical framework. Chapters three to six constitute empirical work. The third and fourth chapters use a grounded theory method to explore surgeons’ perceptions of the content and process of learning in the operating theatre. Chapter five uses case study methodology to illustrate teaching and learning in the operating theatre with concrete examples of pedagogic practice. The sixth chapter is a quasi-experimental study of learning which makes comparison between different pedagogic styles. The final chapter of the thesis draws together the findings from the empirical investigations. The personal development of the researcher is discussed in the first person and the body of research work is critically examined in view of its contribution to the field and its implications for future educational innovation.