Resident, Surgeon, and Perioperative Staff Preconceptions of Intraoperative Video-Based Coaching: A Qualitative Study
Andrew C. Esposito1, Nathan Coppersmith1, Erin M. White1, Mark Chung2, Peter Yoo1
1Department of Surgery, Yale-New Haven Hospital, New Haven, Connecticut, United States, 2Yale University, New Haven, Connecticut, United States
Objective: Examine perceptions of surgical team members regarding the use of video-based coaching (VBC) coaching in the operating room.
Design: A qualitative analysis was undertaken of a series of focus groups. Each focus group was recorded and transcribed. An inductive analysis was performed allowing the establishment of primary and secondary codes that were then thematically analyzed. Data were gathered, coded, and analyzed until no new themes emerged.
Setting: The focus groups were performed virtually at a single, university-affiliated hospital.
Participants: 4 surgical residents in 1 focus groups, 8 surgical attendings in 2 focus groups, and 4 perioperative staff in 1 focus group
Main Outcome Measures: Thematic analysis of the focus group transcripts.
Results: A total of four focus groups were held. None of the residents and only 1 of the 8 attendings had experience with VBC. However, staff participants, comprised of 2 nurse educators, a nurse manager, and a surgical technician all had experience with VBC. Three main themes developed from the analysis: benefits of VBC, logistics of implementation, and potential negative consequences. The first theme, potential benefits, was supported by the subthemes of third person, teaching environment, evidence-based feedback, opening of silos, and improved care delivery all supported the perceived benefits of VBC. All participants believed that VBC could provide benefits for their profession. Attendings discussed how it could improve their teaching style, residents believed it could lead to more rapid uptake of technical skills, and perioperative staff felt it could be used for teaching new hires or review of complex cases. The second theme, logistics of implementation, was further divided into the subthemes of technologic components, frequency of VBC sessions, burden of operating the cameras, patient consent and privacy and interest. The residents, surgeons, and perioperative staff all, incorrectly, believed the other groups were unlikely to perceive VBC's benefits. The final theme, potential negative consequence of surgical recording was supported by the subthemes of the Hawthorn effect and legal consequences. Respondents disagreed as to whether or not video captured for teaching and learning could be used in potential legal proceedings. This uncertainty was endorsed by all participants as the most substantial barrier to implementation of VBC.
Conclusions:
Although respondents enumerated numerous benefits of VBC, several key hurdles were identified. These hurdles pertained to technical logistics as well as significant confusion and apprehension regarding medicolegal consequences of captured video. Successful and widespread implementation of VBC will need to address users' concerns regarding medicolegal implications.
Back to 2022 Posters