Video-based coaching for surgeons in the UK: consensus on essential elements Open Access

Peer-led surgical coaching programmes are recognized increasingly as a performance-enhancing tool for surgeons. In contrast to the established application of video technology in the coaching of elite sportspeople, the use of video analysis within healthcare environments remains limited¹. Audiovisual recording has been integrated successfully into multiple exploratory surgical coaching studies with reported benefit to participants, predominantly in the USA^2,3. The primary aim of this study was to use a modified e-Delphi technique to establish consensus on essential elements of design, implementation, and outcome measurement to inform the development of an audiovisual technology enhanced coaching programme for consultant surgeons in the UK^4,5. The study’s three objectives were to establish the priorities when developing an audiovisually (AV) enhanced surgical coaching programme; gain consensus on essential elements; and rank coaching elements by order of importance to facilitate successful implementation.

A modified e-Delphi study was designed with three sequential rounds utilizing cross-sectional survey design, distributed using REDCap software. (See Supplementary Material S1.) Invited panellists reflected broad and diverse expertise, with those with academic or practical experience of coaching in healthcare, leaders within surgery, medical governance, educationalists, psychologists, and fully qualified general surgeons invited to participate. Purposive sampling was used to promote inclusivity and diversity in recruitment. To mitigate against selection bias, panellists were also identified from research output. Survey statements were rated on level of importance for inclusion in a coaching programme using a 7-point Likert scale (1 = extremely unimportant, 7 = extremely important). Consensus criteria were defined as 70% of participants rating a given statement at 6 or 7. Data were collected between October 2022 and February 2023.

The aim of round 1 was to generate the statements that would be rated in rounds 2 and 3 by establishing panellist perspectives on surgical coaching and the use of audiovisual technology through free-text responses (Supplementary Data S2). Responses were analysed by one researcher (E.G.) and recurring themes identified which were cross checked by a second researcher (S.Y.). Themes were used to generate statements that represented the necessary elements to create and implement a successful surgical coaching programme enhanced by audiovisual recording in the UK. Of the 71 who were invited, 59 experts participated. Ninety-two survey statements were generated regarding surgical coaching and categorized within eight domains: audiovisual technology, programme, formation of coaching pairs, infrastructure, coaching session components, coaching outcome criteria, coaches, and coachees (Supplementary Data S3).

Of the 92 statements considered in Round 2, consensus was reached on 22 statements. Thirty-eight statements were discarded as they were rated a score 6 or a 7 by less than 50% of panellists. The remaining 32 statements were put forward for reconsideration by the panellists in Round 3. Of these statements consensus was found on a further five statements. The 27 consensus statements are displayed in Table 1. The number of statements where consensus was established within their respective domains were Infrastructure: 3, Coaching Session Components: 5, Audiovisual Technology: 4, Programme: 8, Coaches: 5, and Coachees: 2. Notably, consensus was not reached on any of the statements within the Formation of Coaching Pairs or the Coaching Outcome Criteria domains.

The five highest rated statements were: Coaches should be good communicators (90.6%), Clear and formal training for coaches prior to participating (90.1%), Coaches should be good listeners (88.7%), Programme Component: Feedback (88.7%), and Programme Component: Goal Setting/Pre-Session Learning Goal Agreement (88.7%).

This study identified 27 essential elements for a video-based UK surgical coaching programme according to a consensus of leading subject matter experts. These findings can inform user-centred design of a video-based coaching for surgeons.

Funding

Not applicable as no external funding, additional payments or support received.

Disclosures

S.Y. reports research grants from the National Institutes for Health, Canadian Department of National Defence, National Aeronautics and Space Association, Melville Trust for Care and Cure of Cancer, Royal College of Surgeons of Edinburgh, Johnson & Johnson, and is a recent past member of the Global Education Council at the Johnson & Johnson Institute, outside the submitted work. No other authors have anything to disclose.

Supplementary material

Supplementary material is available at BJS Open online.

Data availability

Results data can be made available upon reasonable request.

Author contributions

Eilidh Gunn (Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Visualization, Writing—original draft), Adam Johnson (Data curation, Methodology, Writing—review & editing), Riinu Pius (Data curation, Formal analysis, Methodology, Visualization), Douglas Smink (Conceptualization, Supervision, Writing—review & editing), Andrew Tambyraja (Conceptualization, Methodology, Supervision, Writing—review & editing), and Steven Yule (Conceptualization, Data curation, Formal analysis, Methodology, Supervision, Writing—review & editing)

References

Author notes