Department of Surgery, Wisconsin Surgical Outcomes Research Program, University of Wisconsin, Madison, WI.
Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI.
Ann Surg. 2018 May;267(5):868-873. doi: 10.1097/SLA.0000000000002341.
We sought to develop and evaluate a video-based coaching program for board-eligible/certified surgeons.
Multiple disciplines utilize coaching for continuous professional development; however, coaching is not routinely employed for practicing surgeons.
Peer-nominated surgeons were trained as coaches then paired with participant surgeons. After setting goals, each coaching pair reviewed video-recorded operations performed by the participating surgeon. Coaching sessions were audio-recorded, transcribed, and coded to identify topics discussed. The effectiveness with which our coaches were able to utilize the core principles and activities of coaching was evaluated using 3 different approaches: self-evaluation; evaluation by the participants; and assessment by the study team. Surveys of participating surgeons and coach-targeted interviews provided general feedback on the program. All measures utilized a 5-point Likert scale format ranging from 1 (low) to 5 (high).
Coach-participant surgeon pairs targeted technical, cognitive, and interpersonal aspects of performance. Other topics included managing intraoperative stress. Mean objective ratings of coach effectiveness was 3.1 ± 0.7, ranging from 2.0 to 5.0 on specific activities of coaching. Subjective ratings by coaches and participants were consistently higher. Coaches reported that the training provided effectively prepared them to facilitate coaching sessions. Participants were similarly positive about interactions with their coaches. Identified barriers were related to audio-video technology and scheduling of sessions. Overall, participants were satisfied with their experience (mean 4.4 ± 0.7) and found the coaching program valuable (mean 4.7 ± 0.7).
This is the first report of cross-institutional surgical coaching for the continuous professional development of practicing surgeons, demonstrating perceived value among participants, as well as logistical challenges for implementing this evidence-based program. Future research is necessary to evaluate the impact of coaching on practice change and patient outcomes.
我们旨在为有资格成为委员会认证外科医生的医生开发并评估一个基于视频的指导项目。
多个学科领域都利用指导来进行持续的专业发展；然而，对于执业外科医生来说，指导并未得到常规应用。
同行提名的外科医生接受培训成为指导者，然后与参与外科医生配对。在设定目标后，每对指导者和参与者都会审查参与外科医生记录的手术视频。指导会议会被录音、记录并编码，以确定讨论的主题。使用 3 种不同方法评估我们的指导者运用指导核心原则和活动的有效性：自我评估；参与者评估；和研究团队评估。参与外科医生和指导目标的访谈提供了有关该计划的一般反馈。所有措施都采用 5 分制的李克特量表格式，范围从 1（低）到 5（高）。
指导者-参与者外科医生配对目标是手术表现的技术、认知和人际交往方面。其他主题包括术中压力管理。指导者有效性的客观平均评分是 3.1±0.7，在指导的具体活动中范围从 2.0 到 5.0。指导者和参与者的主观评分始终较高。指导者报告说，培训有效地为他们提供了指导会议的能力。参与者对与他们的指导者的互动也同样持积极态度。确定的障碍与音频-视频技术和会议安排有关。总体而言，参与者对他们的经验感到满意（平均 4.4±0.7），并认为指导项目有价值（平均 4.7±0.7）。
这是首次报告跨机构的外科手术指导，用于执业外科医生的持续专业发展，在参与者中显示出价值，同时也为实施这一基于证据的计划带来了后勤挑战。未来的研究有必要评估指导对实践改变和患者结果的影响。
