A stitch in time: Instructing temporality in the operating room

Area of Science:

• Medical Education
• Surgical Training
• Interaction Analysis

Background:

• Effective surgical performance relies on precise timing.
• Training residents in temporal competence is crucial for patient safety.
• The role of real-time interaction in skill acquisition is understudied.

Purpose of the Study:

• To examine how attending surgeons teach temporal competence to residents during kidney transplant surgeries.
• To identify specific interactional methods used to make time an explicit feature of surgical performance.
• To demonstrate how temporality is made instructable in surgical training.

Main Methods:

• Observational study of kidney transplant surgeries.
• Analysis of attending surgeon-resident interactions.
• Focus on verbal cues, countdowns, and action coordination related to time.

Main Results:

• Attending surgeons use countdowns, pace prompts, and temporal accounts to correct errors.
• Instruction in temporal competence involves coordinating verbal feedback with resident's actions.
• Attending surgeons anticipate and coordinate current and upcoming surgical actions.

Conclusions:

• Temporality is an observable and teachable aspect of surgical performance.
• Real-time interaction is key for instructing temporal competence in surgery.
• This study highlights the importance of temporal awareness in surgical training and practice.