title: Perioperative feedback in surgical training: A systematic review.
abstract: BACKGROUND
  Changes in surgical training have raised concerns about residents' operative exposure and preparedness for independent practice. One way of addressing this concern is by optimizing teaching and feedback in the operating room (OR). The objective of this study was to perform a systematic review on perioperative teaching and feedback.
  
  
  METHODS
  A systematic literature search identified articles from 1994 to 2014 that addressed teaching, feedback, guidance, or debriefing in the perioperative period. Data was extracted according to ENTREQ guidelines, and a qualitative analysis was performed.
  
  
  RESULTS
  Thematic analysis of the 26 included studies identified four major topics. Observation of teaching behaviors in the OR described current teaching practices. Identification of effective teaching strategies analyzed teaching behaviors, differentiating positive and negative teaching strategies. Perceptions of teaching behaviors described resident and attending satisfaction with teaching in the OR. Finally models for delivering structured feedback cited examples of feedback strategies and measured their effectiveness.
  
  
  CONCLUSIONS
  This study provides an overview of perioperative teaching and feedback for surgical trainees and identifies a need for improved quality and quantity of structured feedback.
authors.affiliation: Henry K.M. de Kuyper Education Center, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. Electronic address: katherine.mckendy@mail.mcgill.ca.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: McKendy
authors.affiliation: Henry K.M. de Kuyper Education Center, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. Electronic address: yske328@gmail.com.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. Electronic address: larry.lee@mail.mcgill.ca.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lee
authors.affiliation: Henry K.M. de Kuyper Education Center, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. Electronic address: elif.bilgic@mail.mcgill.ca.
authors.forename: Elif
authors.initials: E
authors.lastname: Bilgic
authors.affiliation: Henry K.M. de Kuyper Education Center, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. Electronic address: ghada.enani@gmail.com.
authors.forename: Ghada
authors.initials: G
authors.lastname: Enani
authors.affiliation: Henry K.M. de Kuyper Education Center, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. Electronic address: liane.feldman@mcgill.ca.
authors.forename: Liane S
authors.initials: LS
authors.lastname: Feldman
authors.affiliation: Henry K.M. de Kuyper Education Center, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. Electronic address: gerald.fried@mcgill.ca.
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Fried
authors.affiliation: Henry K.M. de Kuyper Education Center, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. Electronic address: melina.vassiliou@mcgill.ca.
authors.forename: Melina C
authors.initials: MC
authors.lastname: Vassiliou
mesh_terms: D005246:Feedback; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D009873:Operating Rooms; D059035:Perioperative Period
keywords: Formative feedback; Perioperative teaching; Structured feedback; Surgical education; Systematic review