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Am J Surg. 2017 Jul 1. pii: S0002-9610(17)30198-8. doi: 10.1016/j.amjsurg.2017.06.034. [Epub ahead of print]

Intelligent cooperation: A framework of pedagogic practice in the operating room.

Author information

1
University of Missouri-Kansas City, School of Medicine, Kansas City, MO, USA. Electronic address: sutking@umkc.edu.
2
University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh, PA, USA.
3
University of Missouri-Kansas City, School of Medicine, Kansas City, MO, USA.

Abstract

BACKGROUND:

Surgeons who work with trainees must address their learning needs without compromising patient safety.

METHODS:

We used a constructivist grounded theory approach to examine videos of five teaching surgeries. Attending surgeons were interviewed afterward while watching cued videos of their cases. Codes were iteratively refined into major themes, and then constructed into a larger framework.

RESULTS:

We present a novel framework, Intelligent Cooperation, which accounts for the highly adaptive, iterative features of surgical teaching in the operating room. Specifically, we define Intelligent Cooperation as a sequence of coordinated exchanges between attending and trainee that accomplishes small surgical steps while simultaneously uncovering the trainee's learning needs.

CONCLUSIONS:

Intelligent Cooperation requires the attending to accurately determine learning needs, perform real-time needs assessment, provide critical scaffolding, and work with the learner to accomplish the next step in the surgery. This is achieved through intense, coordinated verbal and physical cooperation.

SUMMARY SENTENCES FOR TABLE OF CONTENTS:

Intelligent Cooperation is defined as a sequence of coordinated exchanges between attending and trainee that accomplishes small surgical steps while simultaneously uncovering the trainee's learning needs. Intelligent Cooperation is achieved through intense, coordinated verbal and physical cooperation and requires the attending to accurately determine learning needs, perform real-time needs assessment, provide critical scaffolding, and work with the learner to accomplish the next step in the surgery.

KEYWORDS:

Attending physician; Education theory; Medical education; Resident physician; Surgery; Surgical education; Video recording

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