Related Experiment Video
Updated: Mar 29, 2026
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
From novice to master surgeon: improving feedback with a descriptive approach to intraoperative assessment
Emily Huang1, Susannah M Wyles1, Hueylan Chern1
1Department of Surgery, University of California, San Francisco, 513 Parnassus Avenue, S-321, San Francisco, CA, 94143-0470, USA.
Background:
A developmental and descriptive approach to assessing trainee intraoperative performance was explored.
Methods:
Semistructured interviews with 20 surgeon educators were recorded, transcribed, deidentified, and analyzed using a grounded theory approach to identify emergent themes. Two researchers independently coded the transcripts. Emergent themes were also compared to existing theories of skill acquisition.
Results:
Surgeon educators characterized intraoperative surgical performance as an integrated practice of multiple skill categories and included anticipating, planning for contingencies, monitoring progress, self-efficacy, and "working knowledge." Comments concerning progression through stages, broadly characterized as "technician," "anatomist," "anticipator," "strategist," and "executive," formed a narrative about each stage of development.
Conclusions:
The developmental trajectory with narrative, descriptive profiles of surgeons working toward mastery provide a standardized vocabulary for communicating feedback, while fostering reflection on trainee progress. Viewing surgical performance as integrated practice rather than the conglomerate of isolated skills enhances authentic assessment.
