Temerty Faculty of Medicine, Unity Health, Toronto, Canada.
Temerty Faculty of Medicine, Unity Health, Toronto, Canada; Division of General Surgery, University of Toronto, Unity Health, Toronto, Canada.
J Am Coll Surg. 2021 Aug;233(2):213-222.e1. doi: 10.1016/j.jamcollsurg.2021.05.011. Epub 2021 Jun 7.
Bile duct injury sustained during laparoscopic cholecystectomy is associated with high morbidity and mortality, and can be a devastating complication for a general surgeon. We introduce a novel, individualized surgical coaching program for surgeons who recently injured a bile duct in laparoscopic cholecystectomy. We aim to explore the perception of coaching among these surgeons and to assess surgeons' experiences in the coaching program.
Six general surgeons who injured a bile duct at an emergency laparoscopic cholecystectomy participated in a 1-on-1 coaching session with a hepatopancreatobiliary surgeon. The session focused on debriefing the index case with video feedback, and discussion of strategies for safe laparoscopic cholecystectomy. The pilot program ran from March to November 2020. Exit interviews were then conducted. Themes covering perception of surgical training, perception of complications, and experience in the coaching program were explored.
Surgeons were generally accepting of the coaching program, especially when the goals aligned with their self-identified areas of development. One-on-1 sessions with a local expert in the area, and the use of video feedback created a unique and interactive coaching opportunity. Peer coaching was identified as a valuable resource in helping surgeons regain confidence and maintain well-being after a bile duct injury. Maintaining a collegial, nonjudgmental relationship is critical in establishing positive coaching experiences.
An individualized surgical coaching program creates a unique opportunity for professional development and may help promote safe laparoscopic cholecystectomy.
腹腔镜胆囊切除术(LC)中发生的胆管损伤与较高的发病率和死亡率相关,并且可能对普通外科医生造成灾难性的并发症。我们为近期在 LC 中胆管损伤的外科医生引入了一种新颖的个体化手术辅导计划。我们旨在探索这些外科医生对辅导的看法,并评估他们在辅导计划中的经验。
6 名在急诊 LC 中损伤胆管的普通外科医生与肝胆胰外科医生进行了 1 对 1 的辅导会议。会议重点是通过视频反馈对索引病例进行汇报,并讨论安全进行 LC 的策略。该试点计划于 2020 年 3 月至 11 月进行。然后进行了离职面谈。探讨了涵盖手术培训认知、并发症认知和辅导计划经验的主题。
外科医生普遍接受辅导计划,尤其是当目标与他们自我确定的发展领域一致时。与该领域的本地专家进行 1 对 1 的会议以及使用视频反馈创造了独特且互动的辅导机会。同行辅导被确定为帮助外科医生在胆管损伤后恢复信心和保持幸福感的有价值资源。保持一种友善、非评判的关系对于建立积极的辅导体验至关重要。
个体化手术辅导计划为专业发展创造了独特的机会,并可能有助于促进安全的 LC。