Comprehensive Surgical Coaching

Surgical Coaching -Using Error Debriefing, Behavioral Modeling and Error Recognition to Enhance Surgical Skill

Simulation in surgical skills training is widely accepted as a necessary step to improve surgical training outside the operating room. Simulation predominately focuses on teaching a specific task or procedure. Once this task is acquired ongoing optimization of technique is desirable. Commonly ongoing skills assessment occurs in the form of peer feedback throughout training rotations. This feedback is frequently subjective and of variable educational use. Identifying ongoing technical training needs and enabling personalized objective feedback represents an important training concept that has not yet been formally used in resident training.

The specific goal of this study is to prove the effect of a comprehensive surgical coaching (CSC) approach which combines concepts of behavior modeling training, task debriefing and error recognition to improve overall surgical technique without additional technical skills training.

Study Overview

• Status: Completed
• Conditions: Surgical Technical Skill; Technical Errors in Surgery
• Intervention / Treatment: Other: Conventional Surgical Training; Other: Comprehensive Surgical Coaching

Detailed Description

Design The study design is a randomized, controlled trial involving evaluation of a study and a conventionally trained group at pretest and posttest.

Participants The study and control groups will consist of senior surgical residents (PGY 3-5) and surgical fellows involved in minimally invasive surgery (MIS).

Inclusion: Since concurrent operative training in the operating room (OR) in the technique of MIS is a prerequisite for this study, only residents and fellows on rotations with a practice focus on MIS during the time period of the study will be eligible for participation.

Exclusion: Individuals with severe illnesses precluding performance in the OR will not be included.

Outcome measures: Surgical performance will be assessed using a global rating scale as well as through tabulation of observed intraoperative technical errors. Primary outcome measure is surgical skill level before and after targeted training.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M5B 1W8
      • St. Michael's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• surgical residents and fellows on rotations with a practice focus on minimally invasive surgery during the time period of the study

Exclusion Criteria:

• individuals with severe illnesses precluding performance in the OR

Study Plan

How is the study designed?

Design Details

• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Conventional residency training; This group will continue their regular surgical training without any specific intervention.	Other: Conventional Surgical Training; Surgical training as per participant's residency program
Experimental: Comprehensive Surgical Coaching (SCS); The participants will receive an analysis of the technical performance as observed on baseline recordings of the index procedure. Training needs will be identified and a personalized coaching concept will be designed. Coaching sessions will include video debriefing of the participant's performance (sample recordings will be submitted by the participant during the sessions) and video assisted behavioral modeling using examples of good and poor technical performance. Coaching will also target increasing awareness of weaknesses and potential pitfalls in surgical technical task execution (error recognition).	Other: Comprehensive Surgical Coaching

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Surgical Technical Skill	Surgical skill measures as recorded on a procedure specific global rating scale, Objective Structured Assessment of Technical Skills (OSATS) and bariatric OSATS (BOSATS) scores and by tabulation of technical errors, Generic Error Rating Tool (GERT) observed during the index procedures.	After 8 weeks of participation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Learning curves	Development of skill and reduction of errors will be assessed in relation to number of procedures performed to obtain learning curves for each study group. Surgical technical skill will be assessed by OSATS and BOSATS scales, errors will be recorded by GERT checklist	Throughout 8 weeks of participation

Collaborators and Investigators

• Sponsor: Unity Health Toronto
• Investigators: Principal Investigator: Teodor P Grantcharov, MD. PhD, St. Michael's Hospital (Toronto, Canada)

Study record dates

Study Major Dates

• Study Start: May 1, 2013
• Primary Completion (Actual): October 1, 2014
• Study Completion (Actual): October 1, 2014

Study Registration Dates

• First Submitted: May 15, 2013
• First Submitted That Met QC Criteria: June 11, 2013
• First Posted (Estimate): June 12, 2013

Study Record Updates

• Last Update Posted (Estimate): May 21, 2015
• Last Update Submitted That Met QC Criteria: May 19, 2015
• Last Verified: May 1, 2015

More Information

Terms related to this study

• Keywords: Surgical education; Deliberate practice; Debriefing; Behaviour modelling
• Other Study ID Numbers: CSC2013

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No