Complementing Operating Room Teaching With Video-Based Coaching.
Importance: Surgical expertise demands technical and nontechnical skills. Traditionally, surgical trainees acquired these skills in the operating room; however, operative time for residents has decreased with duty hour restrictions. As in other professions, video analysis may help maximize the learn...
| Publicado en: | JAMA Surgery Vol. 152; no. 4; pp. 318 - 326 |
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| Autores principales: | , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
American Medical Association
Apr2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122638832&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122638832 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 21686254 FTFX jtl: JAMA Surgery issn: 21686254 maglogo: N pubinfo: dt: Apr2017 vid: 152 iid: 4 pid: 30 pub: American Medical Association place: Chicago, Illinois artinfo: ui: 122638832 122638832 NLM27973648 122638832 10.1001/jamasurg.2016.4619 NLM27973648 122638832 ppf: 318 ppct: 8 formats: tig: atl: Complementing Operating Room Teaching With Video-Based Coaching. aug: au: Yue-Yung Hu Mazer, Laura M. Yule, Steven J. Arriaga, Alexander F. Greenberg, Caprice C. Lipsitz, Stuart R. Gawande, Atul A. Smink, Douglas S. Hu, Yue-Yung affil: Center for Surgery and Public Health, Brigham andWomen's Hospital, Boston, Massachusetts sug: subj: Surgery, Operative Education Internship and Residency Videorecording Problem-Based Learning Operating Rooms ab: Importance: Surgical expertise demands technical and nontechnical skills. Traditionally, surgical trainees acquired these skills in the operating room; however, operative time for residents has decreased with duty hour restrictions. As in other professions, video analysis may help maximize the learning experience.Objective: To develop and evaluate a postoperative video-based coaching intervention for residents.Design, Setting, and Participants: In this mixed methods analysis, 10 senior (postgraduate year 4 and 5) residents were videorecorded operating with an attending surgeon at an academic tertiary care hospital. Each video formed the basis of a 1-hour one-on-one coaching session conducted by the operative attending; although a coaching framework was provided, participants determined the specific content collaboratively. Teaching points were identified in the operating room and the video-based coaching sessions; iterative inductive coding, followed by thematic analysis, was performed.Main Outcomes and Measures: Teaching points made in the operating room were compared with those in the video-based coaching sessions with respect to initiator, content, and teaching technique, adjusting for time.Results: Among 10 cases, surgeons made more teaching points per unit time (63.0 vs 102.7 per hour) while coaching. Teaching in the video-based coaching sessions was more resident centered; attendings were more inquisitive about residents' learning needs (3.30 vs 0.28, P = .04), and residents took more initiative to direct their education (27% [198 of 729 teaching points] vs 17% [331 of 1977 teaching points], P < .001). Surgeons also more frequently validated residents' experiences (8.40 vs 1.81, P < .01), and they tended to ask more questions to promote critical thinking (9.30 vs 3.32, P = .07) and set more learning goals (2.90 vs 0.28, P = .11). More complex topics, including intraoperative decision making (mean, 9.70 vs 2.77 instances per hour, P = .03) and failure to progress (mean, 1.20 vs 0.13 instances per hour, P = .04) were addressed, and they were more thoroughly developed and explored. Excerpts of dialogue are presented to illustrate these findings.Conclusions and Relevance: Video-based coaching is a novel and feasible modality for supplementing intraoperative learning. Objective evaluation demonstrates that video-based coaching may be particularly useful for teaching higher-level concepts, such as decision making, and for individualizing instruction and feedback to each resident. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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