Structured Remote Surgical Coaching to Improve Operative Performance in Laparoscopic Cholecystectomy

NCT04512560 | Completed

• 1 other identifier: SURG-497-20
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Surgical coaching, defined as a constructive relationship that provides objective feedback to individuals about a broad range of factors influencing operative performance, is a key strategy for integrating adult learning theory into the traditionally didactic arena of surgical education. It is gaining momentum as an area of potential growth and innovation, and may become a more meaningful method of ongoing professional development for practicing surgeons. Effective coaching interactions encourage discussion, provide feedback, affirm positive beliefs and challenge pre-existing assumptions. The effectiveness and uptake of coaching interventions in surgery can be influenced by the identity of the coach, and cultural or individual surgeon attitudes. Surgical coaching has been linked to improvements in technical and procedural skills in both simulated and clinical environments. In 2015, a systematic review of surgical coaching showed a positive impact of surgical coaching interventions on learners' perceptions and attitudes, their technical and nontechnical skills, and their performance measures. The investigators propose to conduct a multicenter randomized controlled trial of structured remote surgical coaching (SRSC) versus conventional surgical training for laparoscopic cholecystectomy performed by surgery residents at three institutions, in Canada and Australia, to not only provide additional evidence in support of validity and generalizability of a structured surgical coaching intervention for surgery trainees, but also to demonstrate improvement in accuracy of self-assessment of operative performance and the feasibility of remote coaching.

Conditions

Education; Coaching; Surgical; Laparoscopic; Cholecystectomy

Outcome Measures

Primary Outcomes (2)

• Skill set during performance of a laparoscopic cholecystectomy in the operating room

  Technical skills during a laparoscopic cholecystectomy in the operating room will be one of the primary outcomes for this study. The Global Operative Assessment of Laparoscopic Skills (GOALS) scale will be used to measure this outcome.

  90 days

• Technical errors made during a laparoscopic cholecystectomy in the operating room

  Technical errors during a laparoscopic cholecystectomy in the operating room will be one of the primary outcomes for this study. The Generic Error Rating Tool (GERT) will be used to measure this outcome.

  90 days

Secondary Outcomes (2)

• Subjective assessment of the usefulness of SRSC program

  90 days

• Accuracy of self-assessment

  90 days

Study Arms (2)

Structured Remote Surgical Coaching

EXPERIMENTAL

Participants randomized to the intervention group will participate in a 3-month SRSC program in addition to CST. Participants will be asked to provide a video recording of a laparoscopic cholecystectomy that they performed as a primary surgeon prior to the coaching session. Each coach will review the video recording and will identify key themes for discussion. Coaching sessions will be structured using the modified PRACTICE model, will be conducted outside of the clinical environment, and will employ facilitative coaching methods to encourage participants to define specific intra-operative problems and conceptually troubleshoot various solutions.

Behavioral: Surgical Training using Structured Remote Surgical Coaching in addition to Conventional Surgical Training

Conventional Surgical Training

ACTIVE COMPARATOR

Participants randomized to the control group will continue of their usual general surgery residency training including attending scheduled teaching sessions, and continuing with assigned responsibilities on the ward and in the OR.

Behavioral: Surgical Training using Conventional Training Program

Interventions

Surgical Training using Structured Remote Surgical Coaching in addition to Conventional Surgical Training BEHAVIORAL

General surgery residents (PGY 1-5) will provide a video recording of a laparoscopic cholecystectomy that they performed as a primary surgeon. The coach will identify key moments or themes for discussion on how to improve technical skills and reduce intra-operative errors during five, 30-45 minute remote coaching sessions .

Structured Remote Surgical Coaching

Surgical Training using Conventional Training Program BEHAVIORAL

General surgery residents (PGY 1-5) will continue their usual residency training.

Conventional Surgical Training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• General surgery residents (PGY 1-5) who routinely perform components of laparoscopic cholecystectomy as a primary surgeon (under supervision).

You may not qualify if:

• Individuals with injuries that preclude performance in the operating room will be excluded.

Sponsors & Collaborators

• Dr. Boris Zevin: lead

Study Sites (1)

Queen's University

Kingston, Ontario, K7L4V1, Canada

Location

Study Officials

• Boris Zevin, MD

  Queen's University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Technical skills and technical errors will be assessed by a trainer rater blinded to the participant's group allocation and level of training.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor & Medical Education Scholar

Study Record Dates

• First Submitted: March 31, 2020
• First Posted: August 13, 2020
• Study Start: February 1, 2021
• Primary Completion: July 30, 2024
• Study Completion: July 30, 2024
• Last Updated: October 17, 2024

Record last verified: 2024-07

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)