The Many Faces of Good Operating Room Supervision: Supervisors' and Residents' Perspectives After Operating Together

Abstract

Objective: Effective operating room (OR) learning requires surgical and surgical-educational skills. Current insights into educational skills of surgical educators are derived from general perceptions of supervisors and residents via survey and interview studies. This study aims to provide insight into what educators and residents perceive as good OR supervision behavior based on actual day-to-day collaboration. Additionally, it seeks to explore the underlying goals of good OR supervision and to identify relations between good OR supervision behavior and underlying goals DESIGN: 16 supervisor-resident dyads performing a procedure were video recorded. Directly after the procedure educators and residents independently identified 3 moments of what they perceived as good supervision. During subsequent video-stimulated interviews, they elaborated on why they selected those moments. Thereafter, a qualitative thematic analysis was performed.

Setting: Four common surgical procedures performed by a resident under supervision of a general or orthopedic surgeon in 6 different teaching hospitals in the Netherlands.

Participants: 16 unique supervisor-resident dyads were included in a convenient sample.

Results: Analysis yielded 13 different codes identifying supervisor behaviors and 6 underlying goals of good OR supervision. Which strategy surgical educators use to achieve one of the underlying goals is situation-dependent.

Conclusions: Good supervision is situated and needs to be updated as procedures progress. There is no one-on-one relation between types of good supervision behavior and the underlying goals. As such, a fixed template for effective OR supervision does not exist.

Keywords: operating room learning; resident training; surgical education.