Video-based coaching

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Video-based assessment (VBA) paired with peer coaching provides a structured approach to meet the growing desire globally for objective skills assessments paired with continuous improvement programs geared towards adult learners. Yet, despite encouraging early results of peer coaching initiatives in surgery, this learning modality remains grossly underutilized. To date, only one small, single institution randomized trial has shown that peer coaching translates into measurable technical skills improvements. To drive the cultural and system changes necessary to ensure widespread peer coaching utilization among surgeons, more evidence supporting the feasibility and effectiveness of coaching programs in improving technical skills must be available.

Objective

To conduct the first North America-wide randomized control trial comparing the impact of coaching versus standard practice on video-based assessments of technical proficiency in Nissen fundoplication.

Participants and Roles

Coachees: Surgeons in Canada and U.S.A. within 1-2 years of beginning independent practice who perform 1+ laparoscopic fundoplication, hiatal hernia repair, or Heller myotomy. Upon recruitment, coachees will be randomized to the waitlisted control (VBA only) or intervention arm (VBA and coaching). Coachees in both groups will record five laparoscopic Nissen fundoplications and submit anonymized, unedited copies in which they are the sole operator to SAGES' video platform. Coachees are responsible for obtaining local permissions to record and use anonymized videos at their institutions. Also, baseline demographics and clinical experience must be provided.

Coaches: Subject matter experts (SMEs) in laparoscopic fundoplication who participated in the SAGES Nissen VBA rubric development. Coaches will attend a virtual six-hour training session by the Academy for Surgical Coaching, which is aimed to teach coaches how to adopt the coaching mindset and apply the key skills and core principles of surgical coaching with peer surgeons. Two individualized coaching practice sessions will provide constructive feedback on coaching skills in a one-on-one setting with a surgeon from the coach training, which will result in a coach certificate.

Raters: SMEs in fundoplication who participated in the SAGES Nissen VBA rubric development and have undergone rater training for the video-based assessment (VBA) tools used in this study. Blinded VBAs will be performed at baseline and every three months for a total of five VBAs per participant using OSATS and the newly-developed SAGES Nissen VBA rubric.