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

ABSTRACT

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.