TY - JOUR
T1 - Developing a coaching mechanism for practicing surgeons
AU - Stefanidis, Dimitrios
AU - Anderson-Montoya, Brittany
AU - Higgins, Robert V.
AU - Pimentel, Manuel E.
AU - Rowland, Patrick
AU - Scarborough, Madison O.
AU - Higgins, Danelle
N1 - Funding Information:
Supported through a Leading Edge Advanced Practice Topics grant by the Center for Medicare and Medicaid Services contract number HHSM-500-2012-00028C/000005 .
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background While performance feedback and assessment are hallmarks of surgical training, they abruptly cease after training is completed. In their absence, performance may stagnate and poor habits persist. Our aim was to develop a coaching mechanism for practicing surgeons with feedback provision based on objective performance assessment. Methods Technical and nontechnical intraoperative video recordings from laparoscopic or robotic cholecystectomies, colectomies, and hysterectomies were assessed by a blinded surgeon and a human factors expert, respectively. Aspects of performance in need of improvement were noted, and a coaching session was developed for feedback provision to participating surgeons. This 4-hour coaching session consisted of a didactic lecture with video review and hands-on practice using procedural and mannequin-based simulation. Results Thirty-two practicing surgeons (18 general; 14 gynecologists) from 6 different hospitals were assessed, and 9 of them participated in coaching. Technical aspects identified for performance improvement included suboptimal trocar placement, inadequate critical view achievement during laparoscopic cholecystectomies, poor visualization of the operating field, bimanual dexterity, and dissection techniques, while nontechnical aspects included inappropriate handling of distractions and interruptions, poor ergonomic positioning and situational awareness, and inadequate mitigation of delays. Most surgeons appropriately accomplished some of the objectives of the distraction scenario, but none was able to achieve expert levels on Fundamentals of Laparoscopy tasks. Participants perceived the coaching sessions as highly valuable. Conclusion Our study identified several technical and nontechnical skill sets of practicing surgeons in need of improvement and provided support for the implementation of coaching programs for surgeons on an ongoing basis.
AB - Background While performance feedback and assessment are hallmarks of surgical training, they abruptly cease after training is completed. In their absence, performance may stagnate and poor habits persist. Our aim was to develop a coaching mechanism for practicing surgeons with feedback provision based on objective performance assessment. Methods Technical and nontechnical intraoperative video recordings from laparoscopic or robotic cholecystectomies, colectomies, and hysterectomies were assessed by a blinded surgeon and a human factors expert, respectively. Aspects of performance in need of improvement were noted, and a coaching session was developed for feedback provision to participating surgeons. This 4-hour coaching session consisted of a didactic lecture with video review and hands-on practice using procedural and mannequin-based simulation. Results Thirty-two practicing surgeons (18 general; 14 gynecologists) from 6 different hospitals were assessed, and 9 of them participated in coaching. Technical aspects identified for performance improvement included suboptimal trocar placement, inadequate critical view achievement during laparoscopic cholecystectomies, poor visualization of the operating field, bimanual dexterity, and dissection techniques, while nontechnical aspects included inappropriate handling of distractions and interruptions, poor ergonomic positioning and situational awareness, and inadequate mitigation of delays. Most surgeons appropriately accomplished some of the objectives of the distraction scenario, but none was able to achieve expert levels on Fundamentals of Laparoscopy tasks. Participants perceived the coaching sessions as highly valuable. Conclusion Our study identified several technical and nontechnical skill sets of practicing surgeons in need of improvement and provided support for the implementation of coaching programs for surgeons on an ongoing basis.
UR - http://www.scopus.com/inward/record.url?scp=84992038043&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992038043&partnerID=8YFLogxK
U2 - 10.1016/j.surg.2016.03.036
DO - 10.1016/j.surg.2016.03.036
M3 - Article
C2 - 27302107
AN - SCOPUS:84992038043
SN - 0039-6060
VL - 160
SP - 536
EP - 545
JO - Surgery (United States)
JF - Surgery (United States)
IS - 3
ER -