A Preoperative Educational Time-Out is Associated with Improved Resident Goal Setting and Strengthens Educational Experiences

Heather A. Lillemoe*, David P. Stonko, Brian C. George, Mary C. Schuller, Jonathan P. Fryer, Maura E. Sullivan, Kyla P. Terhune, Sunil K. Geevarghese

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)18-26
Number of pages9
JournalJournal of Surgical Education
Volume77
Issue number1
DOIs
StatePublished - Jan 1 2020

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resident
experience
autonomy
trainee
surgery
deficit
time
Operating Rooms
Liver Transplantation
descriptive statistics
Education
performance
education

Keywords

  • Educational Time-Out
  • Interpersonal and Communication Skills
  • Medical Knowledge
  • Practice-Based Learning and Improvement
  • educational experience
  • perioperative communication
  • resident goal setting

ASJC Scopus subject areas

  • Surgery
  • Education

Cite this

Lillemoe, Heather A. ; Stonko, David P. ; George, Brian C. ; Schuller, Mary C. ; Fryer, Jonathan P. ; Sullivan, Maura E. ; Terhune, Kyla P. ; Geevarghese, Sunil K. / A Preoperative Educational Time-Out is Associated with Improved Resident Goal Setting and Strengthens Educational Experiences. In: Journal of Surgical Education. 2020 ; Vol. 77, No. 1. pp. 18-26.
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abstract = "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.",
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A Preoperative Educational Time-Out is Associated with Improved Resident Goal Setting and Strengthens Educational Experiences. / Lillemoe, Heather A.; Stonko, David P.; George, Brian C.; Schuller, Mary C.; Fryer, Jonathan P.; Sullivan, Maura E.; Terhune, Kyla P.; Geevarghese, Sunil K.

In: Journal of Surgical Education, Vol. 77, No. 1, 01.01.2020, p. 18-26.

Research output: Contribution to journalArticle

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.

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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.

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