Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial
BACKGROUND:Improving surgeons’ technical performance may reduce their frequency of post-operative complications. We conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgical coaching on technical performance among surgeons...
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| Veröffentlicht in: | Plastic and reconstructive surgery (1963) 2020-07, Vol.146 (1), p.144-153 |
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| container_title | Plastic and reconstructive surgery (1963) |
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| creator | Sitzman, Thomas J. Tse, Raymond W. Allori, Alexander C. Fisher, David M. Samson, Thomas D. Beals, Stephen P. Matic, Damir B. Marcus, Jeffrey R. Grossoehme, Daniel H. Britto, Maria T. |
| description | BACKGROUND:Improving surgeons’ technical performance may reduce their frequency of post-operative complications. We conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgical coaching on technical performance among surgeons performing cleft palate repair, in advance of a future effectiveness trial.
METHODS:A non-randomized, two-arm, unblinded pilot trial enrolled surgeons performing cleft palate repair. Participants completed a baseline audit of fistula incidence. Participants with a fistula incidence above the median were allocated to an intensive feedback intervention that included selecting a peer surgical coach, observing the coach perform palate repair, reviewing operative video of their own surgical technique with the coach, and proposing and implementing changes in their technique. All others were allocated to simple feedback (receiving audit results). Outcomes assessed were proportion of surgeons completing the baseline audit, disclosing their fistula incidence to peers, and completing the feedback intervention.
RESULTS:Seven surgeons enrolled in the trial. All seven completed the baseline audit and disclosed their fistula incidence to other participants. The median baseline fistula incidence was 0.4% (range, 0%–10.5%). Two surgeons were unable to receive the feedback intervention. Of the five remaining surgeons, two were allocated to intensive feedback and three to simple feedback. All surgeons completed their assigned feedback intervention. Among surgeons receiving intensive feedback, fistula incidence was 5.9% at baseline and 0.0% following feedback (adjusted odds ratio, 0.98; 95% CI, 0.44–2.17).
CONCLUSIONS:Surgeon-delivered audit and feedback incorporating peer coaching on technical performance was feasible for surgeons.
TRIAL REGISTRATION:ClinicalTrials.gov identifierNCT02583100 |
| doi_str_mv | 10.1097/PRS.0000000000006907 |
| format | Article |
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METHODS:A non-randomized, two-arm, unblinded pilot trial enrolled surgeons performing cleft palate repair. Participants completed a baseline audit of fistula incidence. Participants with a fistula incidence above the median were allocated to an intensive feedback intervention that included selecting a peer surgical coach, observing the coach perform palate repair, reviewing operative video of their own surgical technique with the coach, and proposing and implementing changes in their technique. All others were allocated to simple feedback (receiving audit results). Outcomes assessed were proportion of surgeons completing the baseline audit, disclosing their fistula incidence to peers, and completing the feedback intervention.
RESULTS:Seven surgeons enrolled in the trial. All seven completed the baseline audit and disclosed their fistula incidence to other participants. The median baseline fistula incidence was 0.4% (range, 0%–10.5%). Two surgeons were unable to receive the feedback intervention. Of the five remaining surgeons, two were allocated to intensive feedback and three to simple feedback. All surgeons completed their assigned feedback intervention. Among surgeons receiving intensive feedback, fistula incidence was 5.9% at baseline and 0.0% following feedback (adjusted odds ratio, 0.98; 95% CI, 0.44–2.17).
CONCLUSIONS:Surgeon-delivered audit and feedback incorporating peer coaching on technical performance was feasible for surgeons.
TRIAL REGISTRATION:ClinicalTrials.gov identifierNCT02583100</description><identifier>ISSN: 0032-1052</identifier><identifier>EISSN: 1529-4242</identifier><identifier>DOI: 10.1097/PRS.0000000000006907</identifier><identifier>PMID: 32590658</identifier><language>eng</language><publisher>United States: by the American Society of Plastic Surgeons</publisher><subject>Adult ; Cleft Palate - surgery ; Feasibility Studies ; Female ; Fistula - prevention & control ; Formative Feedback ; Humans ; Male ; Mentoring - methods ; Pilot Projects ; Postoperative Complications - prevention & control ; Reconstructive Surgical Procedures - education</subject><ispartof>Plastic and reconstructive surgery (1963), 2020-07, Vol.146 (1), p.144-153</ispartof><rights>by the American Society of Plastic Surgeons</rights><rights>2020American Society of Plastic Surgeons</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5027-bfbfd0cdc97f4bd2b4fbdf357cfc2d0750c2662384d3ecdff48805f5138ddd003</citedby><cites>FETCH-LOGICAL-c5027-bfbfd0cdc97f4bd2b4fbdf357cfc2d0750c2662384d3ecdff48805f5138ddd003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32590658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sitzman, Thomas J.</creatorcontrib><creatorcontrib>Tse, Raymond W.</creatorcontrib><creatorcontrib>Allori, Alexander C.</creatorcontrib><creatorcontrib>Fisher, David M.</creatorcontrib><creatorcontrib>Samson, Thomas D.</creatorcontrib><creatorcontrib>Beals, Stephen P.</creatorcontrib><creatorcontrib>Matic, Damir B.</creatorcontrib><creatorcontrib>Marcus, Jeffrey R.</creatorcontrib><creatorcontrib>Grossoehme, Daniel H.</creatorcontrib><creatorcontrib>Britto, Maria T.</creatorcontrib><title>Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial</title><title>Plastic and reconstructive surgery (1963)</title><addtitle>Plast Reconstr Surg</addtitle><description>BACKGROUND:Improving surgeons’ technical performance may reduce their frequency of post-operative complications. We conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgical coaching on technical performance among surgeons performing cleft palate repair, in advance of a future effectiveness trial.
METHODS:A non-randomized, two-arm, unblinded pilot trial enrolled surgeons performing cleft palate repair. Participants completed a baseline audit of fistula incidence. Participants with a fistula incidence above the median were allocated to an intensive feedback intervention that included selecting a peer surgical coach, observing the coach perform palate repair, reviewing operative video of their own surgical technique with the coach, and proposing and implementing changes in their technique. All others were allocated to simple feedback (receiving audit results). Outcomes assessed were proportion of surgeons completing the baseline audit, disclosing their fistula incidence to peers, and completing the feedback intervention.
RESULTS:Seven surgeons enrolled in the trial. All seven completed the baseline audit and disclosed their fistula incidence to other participants. The median baseline fistula incidence was 0.4% (range, 0%–10.5%). Two surgeons were unable to receive the feedback intervention. Of the five remaining surgeons, two were allocated to intensive feedback and three to simple feedback. All surgeons completed their assigned feedback intervention. Among surgeons receiving intensive feedback, fistula incidence was 5.9% at baseline and 0.0% following feedback (adjusted odds ratio, 0.98; 95% CI, 0.44–2.17).
CONCLUSIONS:Surgeon-delivered audit and feedback incorporating peer coaching on technical performance was feasible for surgeons.
TRIAL REGISTRATION:ClinicalTrials.gov identifierNCT02583100</description><subject>Adult</subject><subject>Cleft Palate - surgery</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Fistula - prevention & control</subject><subject>Formative Feedback</subject><subject>Humans</subject><subject>Male</subject><subject>Mentoring - methods</subject><subject>Pilot Projects</subject><subject>Postoperative Complications - prevention & control</subject><subject>Reconstructive Surgical Procedures - education</subject><issn>0032-1052</issn><issn>1529-4242</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkd9uFCEUxonR2LX6BsZw6c1Uhj8zs16YbFa3Nmnipq3XhIHDLpYdVmC66eP4pmW7taleKISccPh9H4QPobc1OanJtP2wvLg8IU9GMyXtMzSpBZ1WnHL6HE0IYbSqiaBH6FVKPwipW9aIl-iIUTEljegm6NcCVHK98y7f4mDx5RhXEIbqM3h3AxEMno3GZawGgxcAplf6Gp8NOsRtiCq7YYWXAPFe57TyeB6UXu_bOeALMKMGvHApj17tZc7AUDo2eB92e2ruwWa8VF5lKPxWufgRz_DS-ZDxVXTKv0YvrPIJ3jzUY_R98eVq_rU6_3Z6Np-dV1oQ2la97a0h2uhpa3lvaM9tbywTrbaaGtIKomnTUNZxw0Aba3nXEWFFzTpjTPmpY_Tp4Lsd-w0YDUOOysttdBsVb2VQTv55Mri1XIUb2bLi2oli8P7BIIafI6QsNy5p8F4NEMYkKa-7mpbZFpQfUB1DShHs4zU1kft0ZUlX_p1ukb17-sRH0e84C9AdgF3wGWK69uMOolyD8nn9P2_-D-k9JhivKKGEtGVXlUUbdgfm3cUB</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Sitzman, Thomas J.</creator><creator>Tse, Raymond W.</creator><creator>Allori, Alexander C.</creator><creator>Fisher, David M.</creator><creator>Samson, Thomas D.</creator><creator>Beals, Stephen P.</creator><creator>Matic, Damir B.</creator><creator>Marcus, Jeffrey R.</creator><creator>Grossoehme, Daniel H.</creator><creator>Britto, Maria T.</creator><general>by the American Society of Plastic Surgeons</general><general>American Society of Plastic Surgeons</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200701</creationdate><title>Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial</title><author>Sitzman, Thomas J. ; Tse, Raymond W. ; Allori, Alexander C. ; Fisher, David M. ; Samson, Thomas D. ; Beals, Stephen P. ; Matic, Damir B. ; Marcus, Jeffrey R. ; Grossoehme, Daniel H. ; Britto, Maria T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5027-bfbfd0cdc97f4bd2b4fbdf357cfc2d0750c2662384d3ecdff48805f5138ddd003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Cleft Palate - surgery</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Fistula - prevention & control</topic><topic>Formative Feedback</topic><topic>Humans</topic><topic>Male</topic><topic>Mentoring - methods</topic><topic>Pilot Projects</topic><topic>Postoperative Complications - prevention & control</topic><topic>Reconstructive Surgical Procedures - education</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sitzman, Thomas J.</creatorcontrib><creatorcontrib>Tse, Raymond W.</creatorcontrib><creatorcontrib>Allori, Alexander C.</creatorcontrib><creatorcontrib>Fisher, David M.</creatorcontrib><creatorcontrib>Samson, Thomas D.</creatorcontrib><creatorcontrib>Beals, Stephen P.</creatorcontrib><creatorcontrib>Matic, Damir B.</creatorcontrib><creatorcontrib>Marcus, Jeffrey R.</creatorcontrib><creatorcontrib>Grossoehme, Daniel H.</creatorcontrib><creatorcontrib>Britto, Maria T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Plastic and reconstructive surgery (1963)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sitzman, Thomas J.</au><au>Tse, Raymond W.</au><au>Allori, Alexander C.</au><au>Fisher, David M.</au><au>Samson, Thomas D.</au><au>Beals, Stephen P.</au><au>Matic, Damir B.</au><au>Marcus, Jeffrey R.</au><au>Grossoehme, Daniel H.</au><au>Britto, Maria T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial</atitle><jtitle>Plastic and reconstructive surgery (1963)</jtitle><addtitle>Plast Reconstr Surg</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>146</volume><issue>1</issue><spage>144</spage><epage>153</epage><pages>144-153</pages><issn>0032-1052</issn><eissn>1529-4242</eissn><abstract>BACKGROUND:Improving surgeons’ technical performance may reduce their frequency of post-operative complications. We conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgical coaching on technical performance among surgeons performing cleft palate repair, in advance of a future effectiveness trial.
METHODS:A non-randomized, two-arm, unblinded pilot trial enrolled surgeons performing cleft palate repair. Participants completed a baseline audit of fistula incidence. Participants with a fistula incidence above the median were allocated to an intensive feedback intervention that included selecting a peer surgical coach, observing the coach perform palate repair, reviewing operative video of their own surgical technique with the coach, and proposing and implementing changes in their technique. All others were allocated to simple feedback (receiving audit results). Outcomes assessed were proportion of surgeons completing the baseline audit, disclosing their fistula incidence to peers, and completing the feedback intervention.
RESULTS:Seven surgeons enrolled in the trial. All seven completed the baseline audit and disclosed their fistula incidence to other participants. The median baseline fistula incidence was 0.4% (range, 0%–10.5%). Two surgeons were unable to receive the feedback intervention. Of the five remaining surgeons, two were allocated to intensive feedback and three to simple feedback. All surgeons completed their assigned feedback intervention. Among surgeons receiving intensive feedback, fistula incidence was 5.9% at baseline and 0.0% following feedback (adjusted odds ratio, 0.98; 95% CI, 0.44–2.17).
CONCLUSIONS:Surgeon-delivered audit and feedback incorporating peer coaching on technical performance was feasible for surgeons.
TRIAL REGISTRATION:ClinicalTrials.gov identifierNCT02583100</abstract><cop>United States</cop><pub>by the American Society of Plastic Surgeons</pub><pmid>32590658</pmid><doi>10.1097/PRS.0000000000006907</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0032-1052 |
| ispartof | Plastic and reconstructive surgery (1963), 2020-07, Vol.146 (1), p.144-153 |
| issn | 0032-1052 1529-4242 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7323885 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Cleft Palate - surgery Feasibility Studies Female Fistula - prevention & control Formative Feedback Humans Male Mentoring - methods Pilot Projects Postoperative Complications - prevention & control Reconstructive Surgical Procedures - education |
| title | Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial |
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