TY - JOUR
T1 - A Preoperative Educational Time-Out is Associated with Improved Resident Goal Setting and Strengthens Educational Experiences
AU - Lillemoe, Heather A.
AU - Stonko, David P.
AU - George, Brian C.
AU - Schuller, Mary C.
AU - Fryer, Jonathan P.
AU - Sullivan, Maura E.
AU - Terhune, Kyla P.
AU - Geevarghese, Sunil K.
N1 - Publisher Copyright:
© 2019 Association of Program Directors in Surgery
PY - 2020/1/1
Y1 - 2020/1/1
N2 - OBJECTIVE: The purpose of this study was to assess the impact of a preoperative Educational Time-Out (ETO) with structured postoperative feedback on resident preoperative goal-setting and the educational experience of a clinical rotation. DESIGN: A preoperative ETO was developed during which trainees and faculty jointly identified an operative goal and discussed the trainee's operative autonomy. Postoperative feedback with a smartphone application was encouraged. From November 2016 to October 2017, the intervention was piloted with 1 surgical service. Outcomes included ETO completion rate, goal setting rate, and subjects’ perception of the impact of the ETO on identification of performance deficits, trainee autonomy, and receipt of feedback. Data were analyzed using descriptive statistics. SETTING: This study was performed in an institutional hospital setting. PARTICIPANTS: Third-year general surgery residents and surgical faculty in the Department of Hepatobiliary Surgery and Liver Transplantation at Vanderbilt University Medical Center took part in the intervention. RESULTS: Seven residents and 7 attending surgeons participated in this study. Residents performed a median of 15 procurements during an average of 6.5 weeks each on service. The ETO completion rate was 83%. Resident-reported preoperative goal setting increased after the intervention (from 36% to 78%, p = 0.015). Subjects reported a positive impact of the intervention, with high resident agreement that the ETO helped identify deficits (82% median agreement), increased autonomy (82% median agreement), and increased receipt of feedback (84% median agreement). Residents and attendings agreed that the educational experience was stronger due to the ETO (median 81% and 77%, respectively). CONCLUSIONS: The ETO intervention improved rates of resident preoperative goal setting and strengthened perceived educational experiences. Resident participants also reported improvements in autonomy and rates of postoperative feedback. Broader implementation of this brief preoperative pause is an easy way to emphasize procedural education in the operating room.
AB - OBJECTIVE: The purpose of this study was to assess the impact of a preoperative Educational Time-Out (ETO) with structured postoperative feedback on resident preoperative goal-setting and the educational experience of a clinical rotation. DESIGN: A preoperative ETO was developed during which trainees and faculty jointly identified an operative goal and discussed the trainee's operative autonomy. Postoperative feedback with a smartphone application was encouraged. From November 2016 to October 2017, the intervention was piloted with 1 surgical service. Outcomes included ETO completion rate, goal setting rate, and subjects’ perception of the impact of the ETO on identification of performance deficits, trainee autonomy, and receipt of feedback. Data were analyzed using descriptive statistics. SETTING: This study was performed in an institutional hospital setting. PARTICIPANTS: Third-year general surgery residents and surgical faculty in the Department of Hepatobiliary Surgery and Liver Transplantation at Vanderbilt University Medical Center took part in the intervention. RESULTS: Seven residents and 7 attending surgeons participated in this study. Residents performed a median of 15 procurements during an average of 6.5 weeks each on service. The ETO completion rate was 83%. Resident-reported preoperative goal setting increased after the intervention (from 36% to 78%, p = 0.015). Subjects reported a positive impact of the intervention, with high resident agreement that the ETO helped identify deficits (82% median agreement), increased autonomy (82% median agreement), and increased receipt of feedback (84% median agreement). Residents and attendings agreed that the educational experience was stronger due to the ETO (median 81% and 77%, respectively). CONCLUSIONS: The ETO intervention improved rates of resident preoperative goal setting and strengthened perceived educational experiences. Resident participants also reported improvements in autonomy and rates of postoperative feedback. Broader implementation of this brief preoperative pause is an easy way to emphasize procedural education in the operating room.
KW - Educational Time-Out
KW - Interpersonal and Communication Skills
KW - Medical Knowledge
KW - Practice-Based Learning and Improvement
KW - educational experience
KW - perioperative communication
KW - resident goal setting
UR - http://www.scopus.com/inward/record.url?scp=85069592145&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069592145&partnerID=8YFLogxK
U2 - 10.1016/j.jsurg.2019.07.004
DO - 10.1016/j.jsurg.2019.07.004
M3 - Article
C2 - 31327734
AN - SCOPUS:85069592145
SN - 1931-7204
VL - 77
SP - 18
EP - 26
JO - Journal of Surgical Education
JF - Journal of Surgical Education
IS - 1
ER -