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Authors Glarner CE, Law KE, Zelenski AB, McDonald RJ, Greenberg JA, Foley EF, Wiegmann DA, Greenberg CC
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Journal Am. J. Surg. Volume: 214 Issue: 1 Pages: 141-146
Publish Date 2017 Jul
PubMed ID 28476201
Abstract

The study aim was to explore the nature of intraoperative education and its interaction with the environment where surgical education occurs.Video and audio recording captured teaching interactions between colorectal surgeons and general surgery residents during laparoscopic segmental colectomies. Cases and collected data were analyzed for teaching behaviors and workflow disruptions. Flow disruptions (FDs) are considered deviations from natural case progression.Across 10 cases (20.4 operative hours), attendings spent 11.2 hours (54.7%) teaching, using directing (M = 250.1), and confirming (M = 236.1) most. FDs occurred 410 times, accounting for 4.4 hours of case time (21.57%). Teaching occurred with FD events for 2.4 hours (22.2%), whereas 77.8% of teaching happened outside FD occurrence. Teaching methods shifted from active to passive during FD events to compensate for patient safety.Understanding how FDs impact operative learning will inform faculty development in managing interruptions and improve its integration into resident education.

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