A Novel Operative Coaching Program for General Surgery Chief Residents Improves Operative Efficiency
Open accessAbstract
Introduction We evaluated the effect of an operative coaching (OC) model on general surgery chief residents' operative efficiency (OE) measured by operative times. We hypothesized that higher levels of entrustment surgeons intend to offer resident in future similar cases are associated with improved OE.Materials and methods From July 2018 to June 2019, we used a validated instrument to score prospective resident entrustment in 228 evaluations of 6 chief residents during 12 OC sessions each (3 lap colectomy, 3 lap cholecystectomy, 3 ventral hernia, 3 inguinal hernia). Operative times of matched case CPT codes performed by coached chiefs (N = 500) were matched via CPT code to the cases of uncoached chiefs in the academic year 2016-2017 (N = 478). Statistical analysis was performed using Pearson correlation and one-way ANOVA.Results Prospective entrustment scores from coached chief residents were associated with significantly shorter operative times in matched complex cases (CC) (r = -0.58, p = 0.0047). A similar trend was observed in noncomplex cases (NCC) (r = -0.29, p = 0.18). Compared to the historical cohort, coached chief residents showed a decrease in mean operative time during complex cases (p = 0.0008, d = 0.44), but an increase in mean operative times for noncomplex cases (p < 0.0001, d = 0.33).Conclusions An OC model improves chief residents' prospective entrustment leading to increased OE in cases with greater levels of operative complexity, showing a decrease in mean operative time compared to uncoached residents in certain procedures. This is the first report showing formal coaching may be a method to enhance chief resident OE.
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Comparing intervention vs non-intervention is a coaching measure.
“| Coaching measure | Comparing intervention vs non-intervention | [69,75] |”
From Coaching in undergraduate and graduate medical education: a scoping review of success factors, barriers, and outcomes (2026) · cites this paper as [69]
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Cites
The Transtheoretical Model of Health Behavior Change.
Prochaska, J. O., & Velicer, W. F. (1997) · American Journal of Health Promotion · doi:10.4278/0890-1171-12.1.38 · Cited by 7,782 · see citing works
Feedback and Self-Regulated Learning: A Theoretical Synthesis
Butler, D. L., & Winne, P. H. (1995) · Review of Educational Research · doi:10.3102/00346543065003245 · Cited by 3,334 · see citing works
Davis, D. A., Mazmanian, P. E., Fordis, M., Van Harrison, R., Thorpe, K. E., & Perrier, L. (2006) · JAMA · doi:10.1001/jama.296.9.1094 · Cited by 2,375 · see citing works
Mattar, S. G., Alseidi, A. A., Jones, D. B., Jeyarajah, D. R., Swanstrom, L. L., Aye, R. W., Wexner, S. D., Martinez, J. M., Ross, S. B., Awad, M. M., et al. (2013) · Annals of Surgery · doi:10.1097/sla.0b013e3182a191ca · Cited by 788 · see citing works
What makes for effective feedback: staff and student perspectives
Dawson, P., Henderson, M., Mahoney, P., Phillips, M., Ryan, T., Boud, D., & Molloy, E. (2019) · Assessment & Evaluation in Higher Education · doi:10.1080/02602938.2018.1467877 · Cited by 514 · see citing works
Bonrath, E. M., Dedy, N. J., Gordon, L. E., & Grantcharov, T. P. (2015) · Annals of Surgery · doi:10.1097/sla.0000000000001214 · Cited by 260 · see citing works
Coaching: a new model for academic and career achievement
Deiorio, N. M., Carney, P. A., Kahl, L. E., Bonura, E. M., & Juve, A. M. (2016) · Medical Education Online · doi:10.3402/meo.v21.33480 · Cited by 229 · see citing works
Teman, N. R., Gauger, P. G., Mullan, P. B., Tarpley, J. L., & Minter, R. M. (2014) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2014.04.019 · Cited by 228 · see citing works
Reflection as a Learning Tool in Graduate Medical Education: A Systematic Review
Winkel, A. F., Yingling, S. L., Jones, A., & Nicholson, J. (2017) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-16-00500.1 · Cited by 190 · see citing works
Singh, P., Aggarwal, R. K., Tahir, M., et al. (2014) · Annals of Surgery · doi:10.1097/sla.0000000000000857 · Cited by 162 · see citing works
Greenberg, C. C., Dombrowski, J. C., & Dimick, J. B. (2015) · JAMA Surgery · doi:10.1001/jamasurg.2015.4442 · Cited by 143 · see citing works
Esterhazy, R., & Damşa, C. I. (2017) · Studies in Higher Education · doi:10.1080/03075079.2017.1359249 · Cited by 139 · see citing works
Longitudinal Assessment of Resident Performance Using Entrustable Professional Activities
Schumacher, D. J., West, D. C., Schwartz, A., Li, S. T., Millstein, L. S., Griego, E. C., Turner, T. L., Herman, B. E., Englander, R., Hemond, J., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.19316 · Cited by 136 · see citing works
Cheng, A., Grant, V. J., Huffman, J., Burgess, G., Szyld, D., Robinson, T., & Eppich, W. (2017) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0000000000000232 · Cited by 132 · see citing works
A Statewide Surgical Coaching Program Provides Opportunity for Continuous Professional Development
Greenberg, C. C., Ghousseini, H. N., Quamme, S. R. P., Beasley, H. L., Frasier, L. L., Brys, N. A., Dombrowski, J. C., & Wiegmann, D. A. (2017) · Annals of Surgery · doi:10.1097/sla.0000000000002341 · Cited by 128 · see citing works
Saedon, H., Salleh, S., Balakrishnan, A., Imray, C., & Saedon, M. H. (2012) · BMC Medical Education · doi:10.1186/1472-6920-12-25 · Cited by 124 · see citing works
Moulton, C.-A. E., Regehr, G., Lingard, L. A., Merritt, C. E., & MacRae, H. (2010) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-010-1178-y · Cited by 121 · see citing works
Logan, J. M., Castel, A. D., Haber, S., & Viehman, E. J. (2012) · Metacognition and Learning · doi:10.1007/s11409-012-9090-3 · Cited by 103 · see citing works
Interactive Spaced Education to Assess and Improve Knowledge of Clinical Practice Guidelines
Kerfoot, B. P., Kearney, M., Connelly, D., & Ritchey, M. L. (2009) · Annals of Surgery · doi:10.1097/sla.0b013e31819f6db8 · Cited by 98 · see citing works
Association of Faculty Entrustment With Resident Autonomy in the Operating Room
Sandhu, G., Thompson-Burdine, J., Nikolian, V. C., et al. (2018) · JAMA Surgery · doi:10.1001/jamasurg.2017.6117 · Cited by 95 · see citing works
Identification of behaviors and techniques for promoting autonomy in the operating room
Torbeck, L. J., Wilson, A. B., Choi, J. N., et al. (2015) · Surgery · doi:10.1016/j.surg.2015.05.030 · Cited by 70 · see citing works
Evaluation of the operating room as a surgical teaching venue.
Se, S., Fairholm, D. J., Cochrane, D. D., et al. (1992) · PubMed · Cited by 62 · see citing works
Palter, V. N., Beyfuss, K. A., Jokhio, A. R., Ryzynski, A. A., & Ashamalla, S. (2016) · Surgery · doi:10.1016/j.surg.2016.04.032 · Cited by 48 · see citing works
Resident Autonomy in the Operating Room
Chen, X. P., Sullivan, A. M., Smink, D. S., et al. (2018) · Annals of Surgery · doi:10.1097/sla.0000000000002717 · Cited by 46 · see citing works
Self-citationChen, X. (., Williams, R. G., & Smink, D. S. (2014) · Journal of surgical education · doi:10.1016/j.jsurg.2014.04.010 · Cited by 33 · see citing works
Self-citationEvaluation of an instrument to assess resident surgical entrustable professional activities (SEPAs)
Chen, X. P., Harzman, A. E., Cochran, A. L., et al. (2019) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2019.08.026 · Cited by 27 · see citing works
Self-citationEntrustment Evidence Used by Expert Gynecologic Surgical Teachers to Determine Residents' Autonomy
Chen, X. (., Sullivan, A. M., Bengtson, J. M., et al. (2017) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000002201 · Cited by 23 · see citing works
Self-citationFramework for Faculty Development in Resident Autonomy and Entrustment in the Operating Room
Chen, X. P., Cochran, A. L., & Dalrymple, J. L. (2018) · JAMA Surgery · doi:10.1001/jamasurg.2018.3529 · Cited by 10 · see citing works
Self-citationStep-Specific Guidance is the Strongest Predictor of Prospective Resident Entrustment
Chen, X. P., Cochran, A. L., Harzman, A. E., et al. (2019) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2019.08.787 · Cited by 1 · see citing works
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Research works printed but not linked: 1
- [12]The American Medical Association. Coaching in Medical Education: A Faculty Handbook. Retrieved from https://www.ama-assn.org/system/files/2019-09/coaching-medical-education-faculty-handbook.pdf
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Mukherjee, B., Pfleeger, J., Custodio, H., Roca, M. R., Khalsa, G., & Clanton, C. (2026) · Medical Education Online · doi:10.1080/10872981.2026.2687304 · Cited by 1 · see citing works
- Authors
- Chen, X. (., Cochran, A., Harzman, A. E., & Ellison, E. C.
- Affiliations
- The Ohio State University Wexner Medical Center (US)
- The Ohio State University (US)
- Corresponding author
- Chen, Xiaodong (Phoenix)
- Venue
- Journal of Surgical Education
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 78
- Issue
- 4
- Pages
- 1097-1102
- ISSN
- 1878-7452 (ISSN-L)
- 1931-7204
- PMC
- PMC8217072
- OpenAlex
- W3113688966
- Cited by
- 18
- References
- 29
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 3
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of surgical education (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Advancing Translational Sciences (UL1TR002733)
- Topics
- Health Sciences › Medicine › Surgery › Surgical Simulation and Training
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Keywords
- chief residents, operative efficiency, operative time, entrustment, general surgery residency, surgical complexity, laparoscopic colectomy, laparoscopic cholecystectomy, hernia repair
- MeSH terms
- Mentoring, Clinical Competence, Efficiency, Humans, Internship and Residency, Prospective Studies, General Surgery, Surgeons
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