Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
Ann Surg. 2022 Jan 1;275(1):e91-e98. doi: 10.1097/SLA.0000000000004323.
To evaluate coaching techniques used by practicing surgeons who underwent dedicated coach training in a peer surgical coaching program.
Surgical coaching is a developing strategy for improving surgeons' intraoperative performance. How to cultivate effective coaching skills among practicing surgeons is uncertain.
Through the Surgical Coaching for Operative Performance Enhancement (SCOPE) program, 46 surgeons within 4 US academic medical centers were assigned 1:1 into coach/coachee pairs. All attended a 3-hour Surgical Coaching Workshop-developed using evidence from the fields of surgery and education-then received weekly reminders. We analyzed workshop evaluations and audio transcripts of postoperative debriefs between coach/coachee pairs, co-coding themes based on established principles of effective coaching: (i) self-identified goals, (ii) collaborative analysis, (iii) constructive feedback, and (iv) action planning. Coaching principles were cross-referenced with intraoperative performance topics: technical, nontechnical, and teaching skills.
For the 8 postoperative debriefs analyzed, mean duration was 24.4 min (range 7-47 minutes). Overall, 326 coaching examples were identified, demonstrating application of all 4 core principles of coaching. Constructive feedback (17.6 examples per debrief) and collaborative analysis (16.3) were utilized more frequently than goal-setting (3.9) and action planning (3.0). Debriefs focused more often on nontechnical skills (60%) than technical skills (32%) or teaching-specific skills (8%). Among surgeons who completed the workshop evaluation (82% completion rate), 90% rated the Surgical Coaching Workshop "good" or "excellent."
Short-course coach trainings can help practicing surgeons use effective coaching techniques to guide their peers' performance improvement in a way that aligns with surgical culture.
评估在同行外科指导计划中接受专门指导培训的执业外科医生所使用的指导技术。
外科指导是一种提高外科医生手术表现的发展策略。如何培养执业外科医生有效的指导技能尚不确定。
通过外科手术操作绩效增强指导计划（SCOPE），美国 4 家学术医疗中心的 46 名外科医生被分配为 1:1 的指导/被指导配对。所有参与者均参加了 3 小时的外科指导工作坊——使用来自外科和教育领域的证据开发——然后每周收到提醒。我们分析了工作坊评估和指导/被指导配对之间的术后汇报音频记录，根据有效指导的既定原则对主题进行共同编码：（i）自我确定目标，（ii）协作分析，（iii）建设性反馈，和（iv）行动计划。指导原则与手术中的表现主题交叉参考：技术、非技术和教学技能。
分析了 8 次术后汇报，平均时长为 24.4 分钟（范围为 7-47 分钟）。总体而言，确定了 326 个指导示例，展示了指导的 4 个核心原则的应用。建设性反馈（每次汇报 17.6 个示例）和协作分析（16.3）比目标设定（3.9）和行动计划（3.0）更常使用。汇报更多地关注非技术技能（60%），而不是技术技能（32%）或特定教学技能（8%）。在完成工作坊评估的外科医生中（完成率为 82%），90%的人将外科指导工作坊评为“良好”或“优秀”。
短期的指导培训可以帮助执业外科医生使用有效的指导技巧来指导同行的绩效改进，这与外科文化相一致。
