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Teaching in the operating room: a qualitative mixed-methods review of effective methods
Aboubacar Kaba1, Asha Ayub1, Rashed Kosber1
1Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Background:
Teaching and learning in the operating room environment are unique and impactful experiences. Little is known about effective and ineffective teaching methods. Our objective was to evaluate urology resident attitudes about aspects of teaching in the operating room that are helpful compared with those that are less effective.
Materials And Methods:
Our mixed-methods analysis included written submitted evaluations of faculty by residents from our institution, as well as semi-structured interviews with trainees from different regions of the United States. We separated evaluations of faculty from 1 May 2013 to 30 April 2023 into highest and lowest quartiles based on numeric scores. We then conducted semi-structured interviews with trainees from institutions in different regions of the United States. Open-ended questions allowed participants to express themselves independently, and follow-up discussions explored their perception of effective methods of teaching in the operating room. All evaluations were printed and interviews transcribed. Three blinded, independent reviewers analyzed feedback to identify common themes associated with effective and ineffective teaching in the operating room. We analyzed transcripts using a multistage, cutting-and-sorting technique in an inductive approach based on grounded theory analysis. This work has been reported in line with the Consolidated criteria for Reporting Qualitative Research (COREQ) criteria.
Results:
Our analysis included 22 faculty (11 in each quartile) with an average of 16 evaluations each, as well as 20 transcribed interviews. Effective teaching involved clinician decision-making capability, specific communication, and appropriate graduated responsibility with patience. Ineffective teaching was characterized by poor decision making, lack of actionable communication/feedback, and absence of graduated autonomy/patience. Personal likeability was not a feature of effectiveness.
Conclusion:
Structured analysis of teaching methods in the operating room may allow continuous improvement for all teachers in the academic teaching mission. Further studies may explore consensus panels and potential creation of best practices that can help guide teachers and learners.
