1. Perceptions and observations of coaching A.P.B. Alken, E.C.T.H. Tan, J-M. Luursema, C.R.M.G. Fluit, H. van Goor Radboud University Nijmegen Medical Center, the Netherlands

2. The Definitive Surgical Trauma Care course  Master class for trauma management Learning objective  Treatment of life-threatening injuries by operating team Six complex scenarios  Abdominal and thoracic trauma Live tissue training highly realistic Coaching by faculty Introduction – the DSTC course

3. 1. How did trainees and faculty perceive the coaching? 2. How congruent are these perceptions with observed findings? Study purpose

4. Faculty self reports vs. trainee questionnaires  Faculty report higher satisfaction 1,2 Perceptions vs structured observations  No research Background – prior research 1.Levinson et al. J Grad Med Educ 2010;2(1):31-36. 2.Yarris et al. Acad Emerg Med 2009;16(2):S76–81..

5. DSTC training  11 teams; per team: 1 faculty and 2 trainees Faculty self reports and trainee questionnaires  12 items  1 – 6 (absolutely not/never - absolutely yes/all the time)  Example: “I would describe the feedback as being focused on corrections” “The coaching was directed at the way trainees communicated in the team” Observations  45 minutes of identical scenarios Methods

6. Observational instrument 3 Methods – observational instrument Technical skillsCommunication skills Team skills Reinforced Explanation howNot at all Explanation whyHow and whyExplanation how Not at allExplanation whyHow and why Explanation how Not at allExplanation why 3. Presented at ASE congress 2012 Corrective feedbackPositive feedbackInstruction Reinforced Not at allExplanation how Reinforced Not at all Reinforced Not at allExplanation how Reinforced Not at all Explanation why Explanation how Reinforced Not at all How and whyExplanation why Explanation how Reinforced Not at all How and whyExplanation why Explanation how Reinforced Not at all Explanation how Not at all How and whyExplanation why Explanation how Reinforced Not at allExplanation why Explanation how Not at all How and whyExplanation why Explanation how Reinforced Not at allHow and whyExplanation why Explanation how Not at all How and whyExplanation why Explanation how Reinforced Not at all How and whyExplanation why Explanation how Not at all How and whyExplanation why Explanation how Reinforced Not at all Explanation how Not at allHow and whyExplanation why Explanation how Not at all How and whyExplanation why Explanation how Reinforced Not at all How and why

7. 7 of 12 items matched with observation 1.Corrective feedback 2.Positive feedback 3.Technical skills 4.Communication skills 5.Team skills 6.Explanations why correct 7.Explanations why incorrect Methods – matching variables

8. Comparison Faculty perceptions – trainee perceptions Faculty perceptions – independent observations Trainee perceptions – independent observations Statistical analysis  Mean and median scores  Wilcoxon signed rank tests  Correlations Methods - statistics

9. Faculty vs. trainees Results - perceptions Faculty meansTrainee means Corrective feedback4.6 5.1* Positive feedback 5.0*4.4 Coaching timed well4.4 5.3* Reinforcements why correct4.7 5.2* Reinforcements why incorrect3.9 4.9*

10. Perceptions vs 45 min observations  Mean coaching activities per faculty: 30 times  Faculty vs. observations: coaching on communication skills: ρ =.6 Results – perceptions vs. observations Faculty ratings 6-point scale Trainee ratings 6-point scale Observed count Corrective feedback4.65.12 Positive feedback5.04.42 Instructions26 Technical skills4.64.828 Communication skills4.44.72 Team skills3.84.60.3 Expl. why correct4.65.22 Expl. why incorrect3.94.90 Not reinforced or how28

11. Differences in coaching perceptions faculty and trainees Discrepancy between observation and perception in type of coaching and level of reinforcement Conclusions

12. Overall satisfaction may have contributed 4 Faculty rate to the ideal level 5 Perception questionnaires not always effective Discussion 4.Palter et al. Surg Endosc 2010; 24: 2830-2834. 5.Moorthy K et al. Am J Surg 2006;192:114-118.

13. Thank you!