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Discussion of Non-Technical Skills Through Co-Surgery: A Novel Faculty Development Program for Surgeons
*Alexandra Briggs, *Steven J. Yule, Douglas S. Smink
Brigham and Women's Hospital, Boston, MA
Objective:
It is difficult to create meaningful opportunities for intraoperative professional development for practicing surgeons. To fill this void, our Division of Surgical Oncology initiated a mandatory ‘co-surgery’ program, in which faculty surgeons operate with a surgical colleague annually. This study assessed the utility of this novel program, using structured analysis of dialogue to determine what skills surgeons focused on during co-surgery cases.
Design:
Observational, survey-based study
Setting:
Academic tertiary care center
Participants:
We randomized ten faculty into five co-surgery dyads and observed interactions during routine cases. One surgeon served the role of the attending surgeon, and the other the role of the ‘resident.’
Interventions:
Participants completed pre- and post-case surveys. A trained observer transcribed the dialogue between surgeons during each case.
Main Outcome Measures :
Case transcripts were coded for Technical Skills(TS), Scientific Discussion(SD), Social Interaction(SI), and four categories of non-technical skills: Situation Awareness(SA), Decision Making(DM), Communication/Teamwork(CT), and Leadership(L).
Results:
Five co-surgery procedures were observed. All participants reported the co-surgery to be useful, and wanted to complete it at least annually. Six of ten (60%) reported prior or anticipated changes in practice because of this program. Coding showed that the largest percentage of intraoperative discussion involved SA (24.9%), followed by CT (22.8%), TS (20.3%) and SD (12%). Overall, 59.5% of discussion related to non-technical skills, while only 20.3% related to technical skills.
Conclusions:
Co-surgery is a useful faculty development program that fosters peer-reflection of surgical technique and non-technical skills, and can lead to changes in practice. Non-technical skills were the primary focus of discussion between co-surgeons, demonstrating that the cognitive and behavioral aspects of surgery are important for ongoing faculty education and development.
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