title: A taxonomy of surgeons' guiding behaviors in the operating room.
abstract: BACKGROUND
  This study explores the nature and the intention of attending surgeons' guiding behaviors performed in the operating room (OR) in order to build taxonomy of OR guiding behavior.
  
  
  METHODS
  Nine attending surgeons and 8 surgical residents were invited to observe 8 prerecorded surgical cases from 4 common procedures and completed semistructured interviews. All video-based observations were videotaped. Thematic analysis was applied to identify surgeons' OR guiding behavior.
  
  
  RESULTS
  Seven hundred eighty minutes of video-based observations with interviews were conducted. Sixteen types of OR guiding behaviors in 3 intention-based categories were identified: 3 of the 16 was "teaching" (18.75%), 8 of the 16 was "directing" (50%), and 5 of the 16 was "assisting" (31.25%).
  
  
  CONCLUSIONS
  Surgeons' OR guiding behaviors were grounded in 3 behavioral intentions: teaching, directing, and assisting. This taxonomy of OR guiding behavior can be used as a basis for developing OR guiding strategy to improve residents' intraoperative competency, autonomy, and independence.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: xpchen@partners.org.
authors.forename: Xiaodong Phoenix
authors.initials: XP
authors.lastname: Chen
authors.affiliation: Department of Surgery, Indiana University, 545 Barnhill Drive, Indianapolis, IN 46202.
authors.forename: Reed G
authors.initials: RG
authors.lastname: Williams
authors.affiliation: Department of Surgery, Southern Illinois University, 747 N Rutledge Street, Springfield, IL 62794.
authors.forename: Hilary A
authors.initials: HA
authors.lastname: Sanfey
authors.affiliation: Department of Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Smink
mesh_terms: D005260:Female; D013502:General Surgery / Q000193:education*; D006379:Helping Behavior; D006801:Humans; D007087:Illinois; D033182:Intention; D007396:Internship and Residency; D007400:Interprofessional Relations; D007407:Interviews as Topic; D007857:Leadership; D008297:Male; D009873:Operating Rooms; D017009:Professional Autonomy; D066231:Surgeons / Q000193:education / Q000523:psychology*; D013663:Teaching; D014741:Video Recording
keywords: OR teaching; Operating room guidance; Resident autonomy; Surgical education