Ibrahim I Jabbour1, Dimitrios Stefanidis2, Aimee K Gardner3. 1Florida Atlantic University College of Medicine, 2Indiana University School of Medicine, 3University of Texas Southwestern Medical Center
Background: Coaching has been identified as an effective technique to improve the technical proficiency of surgeons in training and in practice. However, previous work has shown that high levels of feedback disrupt resource allocation and performance for novice learners. Our goal was to examine the effects of a problem-solving coaching style on trainee skill acquisition and physiologic stress. We also investigated the extent to which trainee sensitivity to feedback, also known as self-monitoring ability, impacts coaching effectiveness.
Methods: Third and fourth-year medical students (MS3/4s) were invited to participate in this IRB-approved study. Students first completed a pre training demographics questionnaire, a 12-item self-monitoring ability scale (1=always false, 5=always true), and baseline FLS Task 5 with physiologic sensors. Students were then randomized into coaching or control conditions. Both groups watched a laparoscopic suturing instructional video and were provided 30 minutes to practice the task with or without a coach depending on condition. Coaches logged frequency of coaching behaviors according to a task-specific coaching script. Trainees then completed FLS Task 5 with physiologic sensors, a post training questionnaire with a condition manipulation check, and a 12-item coaching quality evaluation (1=poor, 5=very good).
Results: Twenty-four students (age 24.5 ± 1.4; 54% men; 58% MS4) participated in the study. All were fairly high self-monitors (3.8±0.76). There were no differences in baseline suturing skills between the two groups. Improvement in the coaching group (N=12; 285.0 ± 79.9) was significantly higher than the control group (N=12; 200.9 ± 110.3). One measure of physiologic stress (root mean square of successive heartbeat interval difference; RMSSD) was significantly higher in the coaching group. Trainees who received greater frequency of coaching demonstrated larger improvements (r=0.7, p< 0.05). Overall perceived quality of the coaching relationship was high (4.4 ± 0.6). There was no correlation between trainee self-monitoring ability and skill improvement.
Conclusions: These data support previous work demonstrating the effectiveness of coaching on trainee skill development. This work also suggests that the coaching relationship may increase experienced stress of trainees, but may not necessarily detract from skill improvement. Trainee disposition toward feedback did not play a role in this relationship.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79601
Program Number: P274
Presentation Session: Poster (Non CME)
Presentation Type: Poster