Maximizing peer surgical coaching

“Many surgeons think they understand ‘coaching,’ but it may come as a surprise that teaching, mentoring, and sponsoring are unique from coaching,” said Cara King, DO, director of benign gynecologic surgery at the Cleveland Clinic in Ohio.

Cara King, DO

Peer surgical coaching entails the development of a partnership between two surgeons to identify goals and engage in self-reflection to implement sustainable improvements in both technical and non-technical skills.

King, who was part of a panel on performance coaching at the American Association of Gynecologic Laparoscopists (AAGL) 2020 Virtual Global Congress, told Contemporary OB/GYN that coaching can be challenging to implement, due to the limited time of busy practicing surgeons.

“However, there are many specific actions to enhance coaching integration,” King said. “These include consistent video recording of surgical cases, optimization of surgeon and surgeon coach pairing, utilization of a reliable virtual platform, integration into national societies, and replacement of current surgical education endeavors that may have limited long-term impact.”

A significant training and performance gap exists in ob/gyn training and assessment. “Traditional continuing medical education efforts often do not promote sustainable impact and are commonly not in line with adult learning,” said King, noting that the American Board of Medical Specialties (ABMS) supports a more formable, less summative approach to continuing certification.

The one-on-one relationship between a surgeon and a coach aligns with adult learning and provides a sustainable model to improve clinical performance, patient care and well-being, according to King.

Video-based coaching can also improve performance in surgical trainees. “Surgical video review with performance-based assessment has revealed that decreased technical skill is associated with increased complications,” King said.

In addition, video coaching allows further insight into trainee intraoperative decision-making and failure to progress, “which can be difficult to evaluate using traditional models,” she said. Furthermore, data science is being integrated to enhance the coaching relationship.

However, dedicated faculty development is required to teach coaching philosophy and enhance outcomes. “This is not to discount teaching, mentoring and sponsoring as critical components of professional development,” King said. “But true coaching implementation takes training and practice to master.”

The non-profit Academy for Surgical Coaching is a resource for individual surgeons, national societies, and academic centers to integrate surgical coaching models and empower surgeons.

For high-level coaching, a mind shift is essential for the coach: from an expert role into learner, and from advocating to inquiring. “The coaching philosophy should be focused on goal setting, guided inquiry, constructive feedback and action planning,” King said.

Surgical coaching not only enhances performance improvement, but has the potential to decrease burn out, increase well-being and encourage deep relationships. Content may include technical, cognitive, interpersonal and self-regulation strategies.

“Surgical coaching has the potential to bridge the gap in residency training and continuous professional development,” said King, who is associate program director of the Minimally Invasive Gynecologic Surgery (MIGS) Fellowship at the Cleveland Clinic. “The time has arrived to evaluate, disrupt, and strengthen current surgical education and professional development activities.”

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Disclosures

King reports no relevant financial disclosures.