BACKGROUND: Surgical coaching improves surgeon’s technical and non-technical skills; however, surgeon teaching skills have not been specifically evaluated. In this study, we implement the first described pediatric urology specific faculty-focused coaching model and aim to evaluate the impact on trainee environment and engagement, trainee autonomy, and whether a surgeon’s teaching skills can improve with coaching. METHODS: We designed a coaching model specific to robotic-assisted laparoscopic cases and collected data via REDCap-hosted anonymous surveys from the coachee, trainee(s), and OR staff for each included case. Trainees completed the System for Evaluation of Teaching Qualities (SETQ) for the coachee which was modified from its original version to include three pertinent domains: goal setting, provision of feedback, and global teaching evaluation. The trainees and coachee each completed the Zwisch scale (ZS) to measure autonomy provided to the trainee (scale 1-4, 4=most autonomy). “Meaningful Autonomy” was defined as a score of 3 or 4 / 4 on the ZS. A de novo designed “360 Review Survey” was completed by OR staff (anesthesia, RN, and surgical technician) as an interdisciplinary assessment of trainee environment and engagement. Survey data from July 1, 2023-March 31,2024 were analyzed. Arm 1 consisted of real-time coaching and Arm 2 of remote/post-operative coaching. RESULTS: Two robotic surgeons at our institution were recruited as coachees, one experienced surgeon (>15 years of experience) was recruited as a coach. Forty cases were included (22 = Arm 1, 18 = Arm 2). Survey completion rate for trainees was 64% (35/55: 17 Fellow, 12 PGY2/3, 6 PGY4/5 forms) and 38% for OR staff (53/138). We observed a significant improvement throughout the study period in total SETQ score (38.0 v 45.25, p=0.045) and domains for goal setting (15.0 v 18.0, p=0.030) and global teaching evaluation (8.0 v 9.75, p=0.035) (Figure 1). Majority of responses from the “360 review” were “strongly” positive on 5-point Likert scale (Table 1). We identified an appropriate increase in fellow autonomy (Figure 2). “Meaningful autonomy” as perceived by the trainee was achieved in 70.6% of cases for the fellow, 50% for senior residents (PGY4/5), and 8.3% for junior residents (PGY2/3) with fair agreement (k=0.399, 95% CI 0.220-0.579, p<0.0001) between coachee and trainee reported autonomy. CONCLUSIONS: With faculty-focused surgical coaching, we observed an improvement in surgeon teaching skills, an appropriate increase in fellow autonomy throughout the study period, and a positive and engaging environment for trainees within the operating room. With this, we conclude that implementation of a faculty coaching model would be beneficial to traditional training paradigms.
