Peer-Operative Coaching for Development of Laparoscopic Skills Among General Surgery Trainees

Purpose: While surgical coaching has been supported with a faculty-trainee dynamic, peer-operative coaching at the resident level has not been attempted nor the potential benefits characterized. This study investigates a peer operative coaching program and examines its effects on operative proficiency and self-efficacy in general surgery trainees. Methods: A peer-operative coaching program was designed for two Fundamentals of Laparoscopic Surgery (FLS) skills—peg transfer and circle cut—and piloted for general surgery interns at a single, academic institution. Using a prospective crossover design, changes in time-to-complete task and operative task proficiency were assessed via a modified Objective Structured Assessment of Technical Skills (OSATS) scoring rubric after peer-operative coaching and senior resident coaching. Semi-structured interviews assessed trainee self-efficacy over the duration of the program to elicit perspectives of the peer operative experience, and a thematic analysis was performed. Results: 13 general surgery trainees participated in the program. Trainees demonstrated significantly greater improvement from peer-operative coaching compared to senior resident coaching in time-to-completion and OSATS score for the circle cut task. Inductive analysis of pre- and post-program interview transcripts revealed four pervasive themes from peer operative coaching—comfort with peers, collaborative development, communication improvement, and group motivation. Conclusions: A peer-operative coaching program is feasible in the simulated laparoscopic skills setting for general surgery trainees, and may provide added benefit for skills proficiency acquisition and improved self-efficacy compared to faculty coaching alone. This motivates further work scaling up peer-operative coaching initiatives and assessing their benefits to trainees at other institutions.