Peer operative coaching for development of laparoscopic skills among general surgery trainees

Abstract Purpose While surgical coaching has been supported with a faculty-trainee dynamic, peer-operative coaching at the resident level has not been attempted nor the potential benefits characterized. This study investigates a peer operative coaching program and examines its effects on operative proficiency and self-efficacy in general surgery trainees. Methods A peer-operative coaching program was designed for two Fundamentals of Laparoscopic Surgery (FLS) skills—peg transfer and circle cut—and piloted for general surgery interns at a single, academic institution. Using a prospective crossover design, changes in time-to-complete task and operative task proficiency were assessed via a modified Objective Structured Assessment of Technical Skills (OSATS) scoring rubric after peer-operative coaching and senior resident coaching. Semi-structured interviews assessed trainee self-efficacy over the duration of the program to elicit perspectives of the peer operative experience, and a thematic analysis was performed. Results 13 general surgery trainees participated in the program. Trainees demonstrated significantly greater improvement from peer-operative coaching compared to senior resident coaching in time-to-completion and OSATS score for the circle cut task. Inductive analysis of pre- and post-program interview transcripts revealed four pervasive themes from peer operative coaching—comfort with peers, collaborative development, communication improvement, and group motivation. Conclusions A peer-operative coaching program is feasible in the simulated laparoscopic skills setting for general surgery trainees, and may provide added benefit for skills proficiency acquisition and improved motivation compared to senior coaching alone. This motivates further work scaling up peer-operative coaching initiatives and assessing their benefits to trainees at other institutions.