title: Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room: A Randomized Controlled Trial.
abstract: OBJECTIVE
  The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training.
  
  
  BACKGROUND
  Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge; however, it often remains underutilized. Coaching has been successfully used in various industries to enhance performance, but its role in surgery has been insufficiently investigated.
  
  
  METHODS
  This randomized controlled trial was conducted at one surgical training program. Trainees undergoing a minimally invasive surgery rotation were randomized to either conventional training (CT) or comprehensive surgical coaching (CSC). CT included ward and operating room duties, and regular departmental teaching sessions. CSC comprised performance analysis, debriefing, feedback, and behavior modeling. Primary outcome measures were technical performance as measured on global and procedure-specific rating scales, and surgical safety parameters, measured by error count. Operative performance was assessed by blinded video analysis of the first and last cases recorded by the participants during their rotation.
  
  
  RESULTS
  Twenty residents were randomized and 18 completed the study. At posttraining the CSC group (n = 9) scored significantly higher on a procedure-specific skill scale compared with the CT group (n = 9) [median, 3.90 (interquartile range, 3.68-4.30) vs 3.60 (2.98-3.70), P = 0.017], and made fewer technical errors [10 (7-13) vs 18 (13-21), P = 0.003]. Significant within-group improvements for all skill metrics were only noted in the CSC group.
  
  
  CONCLUSIONS
  Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training.
authors.affiliation: Department of Surgery, University of Toronto, St. Michael's Hospital, Toronto, Canada.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Bonrath
authors.forename: Nicolas J
authors.initials: NJ
authors.lastname: Dedy
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Gordon
authors.forename: Teodor P
authors.initials: TP
authors.lastname: Grantcharov
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D015390:Gastric Bypass / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007582:Jejunostomy / Q000193:education*; D007721:Knowledge of Results, Psychological; D010535:Laparoscopy / Q000193:education*; D008297:Male; D008611:Mentors; D017145:Models, Educational; D009873:Operating Rooms; D018794:Problem-Based Learning / Q000379:methods*