Exploring the Content of Intraoperative Teaching.

Area of Science:

• Medical Education
• Surgical Training
• Operative Room Pedagogy

Background:

• Operating room (OR) is a primary site for surgical resident education.
• Explicit content of OR teaching has not been previously detailed.
• This study focused on laparoscopic cholecystectomies (LCs) using existing cognitive task analysis (CTA).

Purpose of the Study:

• To investigate the explicit teaching content during LCs in the OR.
• To quantify the proportion of technical and decision-making steps that are taught.
• To inform improvements in surgical education strategies.

Main Methods:

• Developed a checklist based on a published CTA for LCs.
• Observed 51 LCs over 12 months (Feb 2011-Feb 2012).
• Recorded explicit teaching related to checklist steps by a trained observer.

Main Results:

• 560 out of 1042 (53.7%) observable teaching points were recorded.
• Technical steps were taught more frequently (67.3%) than decision-making steps (32.7%).
• When focusing on steps alone, technical skills were taught more often (60.9%) than decision-making (43.3%).

Conclusions:

• Approximately half of all observable teaching steps during LCs were explicitly taught.
• Technical aspects of surgery received more teaching emphasis than decision-making.
• Findings can guide curriculum development, faculty training, and resident preparation for OR learning.