Improving surgical excellence: first experience of a video-based intervention in outpatients.

BACKGROUND: There are limited opportunities for surgeons to engage in active learning programs once they achieve Fellowship, especially for non-technical skills such as communication. This study aims to address this gap by evaluating a peer-based coaching program in non-technical skill using video-recorded patient consultations from a routine outpatient clinic. METHODS: Standard outpatient consultations between consultant surgeons and patients were video recorded. The surgeon viewed the videos with a peer-coach (senior surgeon) who helped identify areas of strength and areas for improvement. To test the effect of the coaching session, outpatient consultations were recorded roughly 1 month later. Pre and post-coaching videos were assessed using the Maastricht History-Taking and Advice Scoring - Global Rating List (MAAS), a common tool for evaluating non-technical skills in clinicians. RESULTS: A total of 12 surgeons consented to participate. Coaching significantly improved MAAS scores (mean difference = -0.61; 95% CI (-0.88, -0.33); P < 0.0001). Surgeons were generally positive about the experience. All found the method of learning suitable, and most thought the process improved their skills. Most thought that coaching would improve patient outcomes and the majority thought they would participate in ongoing coaching as part of their employment. CONCLUSION: This supports the concept of surgical coaching as an effective tool to improve communication skills and the quality of surgical consultation. The next step is to expand beyond a voluntary cohort and link surgical coaching to improved patient outcomes.

Peer Coaching as a Form of Performance Improvement: What Surgeons Really Think.

OBJECTIVE: Coaching has been proposed as a potential form of continuing professional development (CPD) for surgeons. Our study aimed to elicit qualified surgeons' perceptions of peer coaching as a form of CPD and to determine the effect of demographic factors on surgeons' views. METHODS: A cross-sectional paper survey was conducted across 2 South Australian metropolitan hospitals from November 2018 to January 2019. This comprised 5 demographic questions and 6 Likert items eliciting views on peer-based coaching and was distributed at departmental unit meetings to surgical consultants and fellows. Participation was voluntary and a definition of "peer-based coaching" was provided. RESULTS: Hundred and eighteen surgeons of a possible 125 (94.4% response rate) from 8 surgical specialties completed the survey with 45.4% (n = 54) having received coaching since obtaining their fellowship. The majority of participants (72.9%, n = 86) reported consultant surgeons would benefit from peer coaching and that one-on-one coaching in an individual setting would be a useful CPD activity (73.7%, n = 87). Just over half the participants (53.4%, n = 63) felt that coaching by a nonsurgeon such as a psychologist would benefit their nonoperative skills. Many participants (61.8%, n = 73) felt more inclined to participate if CPD points were awarded. Despite the support in favor of coaching, a significant percentage of participants (45.8%, n = 54) wanted further evidence of its efficacy. CONCLUSIONS: There is support amongst surgeons for peer coaching and its inclusion as a form of CPD, however, many require more evidence of its benefits, thus highlighting the need for ongoing research studies, consultation and pilot coaching programs.