Perceptions and observations of coaching

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. Introduction – the DSTC course • 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

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

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

5. Methods • 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

6. Methods – observational instrument • Observational instrument 3 Explanation why Explanation why Explanation why Explanation why Explanation why Explanation why Explanation why Explanation why Explanation why Explanation how Explanation how Explanation how Explanation how Explanation how Explanation how Explanation why Explanation why Explanation why Explanation why Explanation why How and why How and why How and why How and why Explanation how Explanation how How and why How and why How and why How and why How and why How and why How and why How and why Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Not at all Explanation how Explanation how Explanation how Explanation how Explanation how Explanation how Explanation how Explanation how Explanation how Explanation how Explanation how Explanation why How and why 3. Presented at ASE congress 2012

7. Methods – matching variables • 7 of 12 items matched with observation • Corrective feedback • Positive feedback • Technical skills • Communication skills • Team skills • Explanations why correct • Explanations why incorrect

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

9. Results - perceptions • Faculty vs. trainees

10. Results – perceptions vs. observations • Perceptions vs 45 min observations • Mean coaching activities per faculty: 30 times • Faculty vs. observations: coaching on communication skills: ρ = .6

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

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

13. Thank you!