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Am J Surg. 2016 Jul;212(1):180-7. doi: 10.1016/j.amjsurg.2015.04.026. Epub 2015 Oct 20.

From novice to master surgeon: improving feedback with a descriptive approach to intraoperative assessment.

Author information

1
Department of Surgery, University of California, San Francisco, 513 Parnassus Avenue, S-321, San Francisco, CA, 94143-0470, USA. Electronic address: Emily.Huang2@ucsf.edu.
2
Department of Surgery, University of California, San Francisco, 513 Parnassus Avenue, S-321, San Francisco, CA, 94143-0470, USA.
3
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.

Abstract

BACKGROUND:

A developmental and descriptive approach to assessing trainee intraoperative performance was explored.

METHODS:

Semistructured interviews with 20 surgeon educators were recorded, transcribed, deidentified, and analyzed using a grounded theory approach to identify emergent themes. Two researchers independently coded the transcripts. Emergent themes were also compared to existing theories of skill acquisition.

RESULTS:

Surgeon educators characterized intraoperative surgical performance as an integrated practice of multiple skill categories and included anticipating, planning for contingencies, monitoring progress, self-efficacy, and "working knowledge." Comments concerning progression through stages, broadly characterized as "technician," "anatomist," "anticipator," "strategist," and "executive," formed a narrative about each stage of development.

CONCLUSIONS:

The developmental trajectory with narrative, descriptive profiles of surgeons working toward mastery provide a standardized vocabulary for communicating feedback, while fostering reflection on trainee progress. Viewing surgical performance as integrated practice rather than the conglomerate of isolated skills enhances authentic assessment.

KEYWORDS:

Assessment; Feedback; Intraoperative development; Skill; Surgical education; Teaching

PMID:
26611717
DOI:
10.1016/j.amjsurg.2015.04.026
[Indexed for MEDLINE]

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