S. J. Rivard1, C. Varlamos1, C. Hibbard1, A. Duby1, M. Callow1, J. Dimick1, J. Byrn1, M. Byrnes1 1University of Michigan,Ann Arbor, MI, USA
Introduction: Previous work revealed a clinically-significant wide variation in adjusted outcomes for surgeons performing minimally invasive colectomies. Inspired by the landmark work that showed the benefit of surgical coaching, the Michigan Surgical Quality Collaborative Video Colectomy Project was designed to improve surgeon technical skill and patient outcomes by expanding on coaching frameworks through group video based formative feedback. However, little is known about surgeons’ experience with surgical coaching, which is an emerging field. We performed qualitative interviews of surgeons participating in our Video Colectomy Project as well as non-participating surgeons across the U.S.
Methods: Data for this study is part of an ongoing longitudinal qualitative intervention with colorectal surgeons in the state of Michigan. To inform our ongoing research, we interviewed 14 surgeons participating in the Video Colectomy Project as well as 68 colorectal surgeons across the U.S. to gauge attitudes and perceptions around surgical coaching. Interviews were coded in a team-based approach. We report our results thematically.
Results: Participants and non-participants had little familiarity with surgical coaching. Most surgeons outside the state of Michigan revealed they had never heard about the practice. However, after hearing a brief description, participants “welcomed” and were “excited” about opportunities for technical improvement. Surgeons who participated discussed motivations to participations: desire to improve technically and peer affirmation. Surgeons differed in what formal technical improvement feedback should look like with responses most often paralleling what surgeons believed was culturally appropriate or feasible to their practice. Some were most interested in a group video coaching model while others were envisioning a one-on-one intraoperative surgical coach. When discussing logistics, most surgeons believed that professional surgical societies should offer some form of peer technical improvement opportunities. Some surgeons discussed coaches for skills outside of the operating room, such as managing ethical dilemmas or communication skills with difficult patients or colleagues. Surgeons considered several barriers to a successful surgical coaching program, including surgeon time, required vulnerability, technical concerns, and the ability to make a coaching program relevant to all surgeons.
Conclusion: Surgeons were attracted to the concept of surgical coaching to improve their technical skills and for continued professional development. However, surgeons had varying views about the ideal surgical coaching program and recognized many challenging barriers to widespread adoption. We hope to continue to develop our surgical coaching program based on our participating surgeons’ experiences and continued feedback. We also hope to deliver both technically and culturally appropriate coaching for surgeons nationwide.