Soelling Stefanie J, Sinyard Robert D, Spigel Lauren, Riley Max, Gregory Paul, Perdomo Nick, Sonnay Yves, Yule Steven, Fishman Steven J, Smink Douglas S
From the Department of Surgery, Brigham & Women's Hospital, Boston, MA.
Ariadne Labs, Harvard School of Public Health, Brigham and Women's Hospital, Boston, MA.
Ann Surg Open. 2024 Dec 12;5(4):e532. doi: 10.1097/AS9.0000000000000532. eCollection 2024 Dec.
Surgery has seen limited adoption of 360-degree feedback tools, and no current tools evaluate intraoperative performance from a technical, nontechnical, or teaching skill perspective. We sought to evaluate the overall findings and perceived value of a novel 360-degree feedback tool for surgeons from their operating room colleagues.
The 'intraoperative 360' (i360) combined 3 previously validated scales of surgeon performance. The electronic medical record at a single academic medical center was queried for perioperative staff involvement in recent cases for a cohort of surgeons. Staff with frequent surgeon case involvement were emailed a link to an anonymous i360 survey. Aggregated survey responses were provided to surgeons and surgical leadership. We performed semi-structured interviews with 10 surgeons and 5 surgical leaders. Combined inductive and deductive coding was used to determine their perceptions regarding the utility of and barriers to the i360.
Over 2-years, a total of 960 surveys were completed for 88 surgeons. The composite rating of technical skills was 4.87/5 (SD: 0.36); nontechnical skills, 4.65/5 (SD: 0.55); and teaching skills, 2.92/3 (SD: 0.24). There was no difference in mean scores based on gender, age, or years of tenure. Six themes emerged from the interviews: initial reactions, utility, additional needs, other feedback mechanisms, reciprocal feedback, and logistical challenges.
A 360-degree feedback tool is feasible, and feedback is perceived as valuable and actionable for surgeons and surgeon leaders. The intraoperative focus provided surgeons with specific feedback on how to improve within the operating room to promote efficiency, teamwork, and patient safety.
手术领域对360度反馈工具的采用有限，目前尚无工具从技术、非技术或教学技能角度评估术中表现。我们试图评估一种新型360度反馈工具对手术室同事眼中外科医生的总体评价及感知价值。
“术中360”（i360）结合了3个先前验证过的外科医生表现量表。在一家学术医疗中心查询电子病历，以确定围手术期工作人员参与的一组外科医生近期病例情况。向经常参与外科医生病例的工作人员发送匿名i360调查链接。将汇总的调查回复提供给外科医生和外科领导层。我们对10名外科医生和5名外科领导层进行了半结构化访谈。采用归纳和演绎相结合的编码方法来确定他们对i360实用性和障碍的看法。
在两年多时间里，共为88名外科医生完成了960份调查。技术技能的综合评分为4.87/5（标准差：0.36）；非技术技能为4.65/5（标准差：0.55）；教学技能为2.92/3（标准差：0.24）。基于性别、年龄或任期的平均得分没有差异。访谈中出现了六个主题：初始反应、实用性、额外需求、其他反馈机制、相互反馈和后勤挑战。
360度反馈工具是可行的，对于外科医生和外科领导层而言，反馈被视为有价值且可采取行动的。术中重点为外科医生提供了关于如何在手术室内改进以提高效率、团队合作和患者安全的具体反馈。
