Surgical Coaching for Operative Performance Enhancement (SCOPE): skill ratings and impact on surgeons' practice.

Continuous professional development Intraoperative performance Non-technical skills Surgeon well-being Surgical coaching Technical skills

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
07 2021
Historique:
received: 07 04 2020
accepted: 01 07 2020
pubmed: 10 7 2020
medline: 30 9 2021
entrez: 10 7 2020
Statut: ppublish

Résumé

Evidence for surgical coaching has yet to demonstrate an impact on surgeons' practice. We evaluated a surgical coaching program by analyzing quantitative and qualitative data on surgeons' intraoperative performance. In the 2018-2019 Surgical Coaching for Operative Performance Enhancement (SCOPE) program, 46 practicing surgeons in multiple specialties at four academic medical centers were recruited to complete three peer coaching sessions, each comprising preoperative goal-setting, intraoperative observation, and postoperative debriefing. Coach and coachee rated the coachee's performance using modified Objective Structured Assessment of Technical Skills (OSATS, range 1-5) and Non-Technical Skills for Surgeons (NOTSS, range 4-16). We used generalized estimating equations to evaluate trends in skill ratings over time, adjusting for case difficulty, clinical experience, and coaching role. Upon program completion, we analyzed semi-structured interviews with individual participants regarding the perceived impact of coaching on their practice. Eleven of 23 coachees (48%) completed three coaching sessions, three (13%) completed two sessions, and six (26%) completed one session. Adjusted mean OSATS ratings did not vary over three coaching sessions (4.39 vs 4.52 vs 4.44, respectively; P = 0.655). Adjusted mean total NOTSS ratings also did not vary over three coaching sessions (15.05 vs 15.50 vs 15.08, respectively; P = 0.529). Regarding patient care, participants self-reported improved teamwork skills, communication skills, and awareness in and outside the operating room. Participants acknowledged the potential for coaching to improve burnout due to reduced intraoperative stress and enhanced peer support but also the potential to worsen burnout by adding to chronic work overload. Surgeons reported high perceived impact of peer coaching on patient care and surgeon well-being, although changes in coachees' technical and non-technical skills were not detected over three coaching sessions. While quantitative skill measurement warrants further study, longitudinal peer surgical coaching should be considered a meaningful strategy for surgeons' professional development.

Sections du résumé

BACKGROUND
Evidence for surgical coaching has yet to demonstrate an impact on surgeons' practice. We evaluated a surgical coaching program by analyzing quantitative and qualitative data on surgeons' intraoperative performance.
METHODS
In the 2018-2019 Surgical Coaching for Operative Performance Enhancement (SCOPE) program, 46 practicing surgeons in multiple specialties at four academic medical centers were recruited to complete three peer coaching sessions, each comprising preoperative goal-setting, intraoperative observation, and postoperative debriefing. Coach and coachee rated the coachee's performance using modified Objective Structured Assessment of Technical Skills (OSATS, range 1-5) and Non-Technical Skills for Surgeons (NOTSS, range 4-16). We used generalized estimating equations to evaluate trends in skill ratings over time, adjusting for case difficulty, clinical experience, and coaching role. Upon program completion, we analyzed semi-structured interviews with individual participants regarding the perceived impact of coaching on their practice.
RESULTS
Eleven of 23 coachees (48%) completed three coaching sessions, three (13%) completed two sessions, and six (26%) completed one session. Adjusted mean OSATS ratings did not vary over three coaching sessions (4.39 vs 4.52 vs 4.44, respectively; P = 0.655). Adjusted mean total NOTSS ratings also did not vary over three coaching sessions (15.05 vs 15.50 vs 15.08, respectively; P = 0.529). Regarding patient care, participants self-reported improved teamwork skills, communication skills, and awareness in and outside the operating room. Participants acknowledged the potential for coaching to improve burnout due to reduced intraoperative stress and enhanced peer support but also the potential to worsen burnout by adding to chronic work overload.
CONCLUSIONS
Surgeons reported high perceived impact of peer coaching on patient care and surgeon well-being, although changes in coachees' technical and non-technical skills were not detected over three coaching sessions. While quantitative skill measurement warrants further study, longitudinal peer surgical coaching should be considered a meaningful strategy for surgeons' professional development.

Identifiants

pubmed: 32642845
doi: 10.1007/s00464-020-07776-1
pii: 10.1007/s00464-020-07776-1
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3829-3839

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Auteurs

Jason C Pradarelli (JC)

Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Floor West, Boston, MA, 02215, USA. jpradarelli@partners.org.
Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. jpradarelli@partners.org.

Steven Yule (S)

Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Floor West, Boston, MA, 02215, USA.
Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Stuart R Lipsitz (SR)

Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Floor West, Boston, MA, 02215, USA.

Nikhil Panda (N)

Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Floor West, Boston, MA, 02215, USA.
Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.

Molly Craig (M)

Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Kurt W Lowery (KW)

Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Floor West, Boston, MA, 02215, USA.

Stanley W Ashley (SW)

Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Denise W Gee (DW)

Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.

Peter M Waters (PM)

Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, USA.

Jim Knight (J)

Kansas Coaching Project, Center for Research on Learning, University of Kansas, Lawrence, KS, USA.

Douglas S Smink (DS)

Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Floor West, Boston, MA, 02215, USA.
Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.

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