Impact of Objectively Assessing Surgeons’ Teaching on Effective Perioperative Instructional Behaviors

IMPORTANCE Advancing surgical technology and decreasing resident learning hours have limited exposure to perioperative training, necessitating more effective and efficient perioperative teaching by faculty surgeons. Participation in collaborative efforts and process improvement can change behaviors and enhance teaching. OBJECTIVES To promote deliberate teaching of residents, change resident perception of their teachers, and produce sustainable improvements by objectively measuring surgeons’ perioperative teaching performance. DESIGN, SETTING, AND PARTICIPANTS This 3-phase observational study of surgeons’ perioperative teaching behaviors included university-based surgeons, general surgery residents, and preclinical student observers and involved elective cases at a 600+ bed tertiary hospital. Initially, we measured teaching behaviors by surgeons unaware of study objectives, provided aggregate and confidential individual feedback, and developed standardized preoperative briefings and postoperative debriefings. Phase 2 applied a deliberate teaching model and reinforced behaviors with continuous process improvement efforts (Plan, Do, Check, Act) and repeat observations. Phase 3 used resident prompts to enhance teaching behaviors and demonstrate sustainability. Resident surveys conducted 3 times assessed perceptions of deliberate guidance by faculty when compared with national benchmarks. INTERVENTIONS Introduction of deliberate faculty preprocedural focusing and postprocedural reinforcement to facilitate resident learning. MAIN OUTCOMES AND MEASURES More frequent and complete perioperative teaching by faculty and the perception of enhanced teaching by residents. RESULTS Faculty more commonly and more completely performed the 10-step preoperative briefings and postoperative debriefings (P