Enhancing Operative Feedback: A Descriptive Trajectory for Surgical Development in Otolaryngology

Objective: Developmental frameworks are narrative descriptions of learner performance that may be useful to provide operative feedback tools in surgical education. The authors previously proposed the Technician, Anatomist, Anticipator, Strategist, Executive (TAASE) framework utilizing data collected from general surgeons and conjectured its applicability in other surgical specialties. Here, we construct a developmental framework in otolaryngology using similar techniques, then compare the results to TAASE.

Design: Ten otolaryngology educators participated in semi-structured, audio-recorded interviews, to explore how otolaryngology faculty characterize surgical learning at different levels of training. Researchers analyzed the transcripts using a thematic analysis approach to build a developmental framework. Results were then qualitatively compared to the TAASE trajectory.

Setting: Single tertiary academic medical center.

Participants: Faculty within the Department of Otolaryngology-Head and Neck Surgery.

Results: Otolaryngology faculty characterized surgical development as an integrated trajectory of technical and cognitive skills progressing from specific operative tasks to a global understanding of patients and procedures largely consistent with stages outlined in the Technician, Anatomist, Anticipator, Strategist, and Executive model. A new theme identified was learner emotions, which may impact learning and hinder or enhance progression along the trajectory.

Conclusions: Otolaryngology and general surgeons agree upon a common arc to operative maturity reflected by the TAASE trajectory. The TAASE framework may be useful as a tool for intraoperative assessment in otolaryngology to help promote quality feedback. Further research is needed to understand how emotions may influence operative skill development.