title: Coaching Surgeons: Is Culture Limiting Our Ability to Improve?
abstract: OBJECTIVE
  To explore surgeons' perceptions of and potential concerns about coaching.
  
  
  BACKGROUND
  There is growing recognition that the traditional model of continuing professional development is suboptimal. This has led to increasing interest in alternative strategies that take place within the actual practice environment such as coaching. However, if coaching is to be a successful strategy for continuing professional development, it will need to be accepted by surgeons.
  
  
  METHODS
  This was a qualitative interview-based study using a constructivist grounded theory approach. Participants included 14 surgeons from University of Toronto-affiliated hospitals.
  
  
  RESULTS
  Participants expressed 3 main concerns about coaching: questioning the value of technical improvement ("As you get older if you don't have the stimulation from surgery to get better or to do things that are different and you are so good at so much, why bother [with coaching]?" P009), worry about appearing incompetent ("I think it would be perceived as either a sign of weakness or a sign of inability" P532), and concern about losing autonomy ("To me that would be real coaching where it's self-identified, I'm motivated, I find the person and then they coach me" P086).
  
  
  CONCLUSIONS
  Coaching faces unique challenges in the context of a powerful surgical culture that values the portrayal of competency and instills the value of surgical autonomy. This study suggests that hanging on to these tightly held values of competency and autonomy is actually limiting the ways, and extent to which, surgeons can improve their practice.
authors.affiliation: *Department of Surgery, University of Toronto, Toronto, Ontario, Canada †Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada ‡The Wilson Centre, University of Toronto, Toronto, Ontario, Canada §SickKids Learning Institute, Hospital for Sick Children, Toronto, Ontario, Canada ¶Division of Orthopedics, Hospital for Sick Children, Toronto, Ontario, Canada ‖Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada **Department of Surgery and Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada ††Division of General Surgery, University Health Network, Toronto, Ontario, Canada.
authors.forename: Dorotea
authors.initials: D
authors.lastname: Mutabdzic
authors.forename: Maria
authors.initials: M
authors.lastname: Mylopoulos
authors.forename: Michael Lucas
authors.initials: ML
authors.lastname: Murnaghan
authors.forename: Priyanka
authors.initials: P
authors.lastname: Patel
authors.forename: Nathan
authors.initials: N
authors.lastname: Zilbert
authors.forename: Natashia
authors.initials: N
authors.lastname: Seemann
authors.forename: Glenn
authors.initials: G
authors.lastname: Regehr
authors.forename: Carol-Anne
authors.initials: CA
authors.lastname: Moulton
mesh_terms: D001291:Attitude of Health Personnel / Q000208:ethnology*; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008611:Mentors; D017145:Models, Educational; D009873:Operating Rooms; D018794:Problem-Based Learning / Q000379:methods*; D017009:Professional Autonomy; D012649:Self Concept; D013043:Specialties, Surgical / Q000193:education*; D066231:Surgeons / Q000523:psychology*