Surgical Assessments: Current State, Ideal State, and Considerations for Implementation. A Qualitative Interview
Michelle J Clarke1, Roger A Edwards2, Bobbie Ann Adair White2
1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
Objective:
This qualitative study explored trainee and faculty perceptions of procedural and surgical assessment and feedback, including current state, aspirational future state, and the factors affecting implementation of a formal assessment systems.
Methods:
Data were collected with semi-structured interviews of 10 surgical faculty and 10 surgical trainees. The in-depth, semi-structured interviews included open-ended questions with targeted follow-up probing around the following topics (1) the current surgical assessment and feedback process, (2) requirements for future surgical assessments, and (3) perceived barriers and facilitators to implementing a new surgical assessment and feedback system. Braun and Clarke's iterative 6-stage thematic analysis was used to analyze the data.
Results:
Seven themes were identified from participants' perceptions of surgical assessments and feedback: (1) Purpose of evaluation and assessment, (2) Assessment in service of feedback, (3) Outcome of evaluation and assessment, (4) Interpersonal relationships trump technology, (5) Challenges of constructive feedback, (6) Development of assessment tool, and (7) Utility is critical to success. Key facilitators to adopting a formal assessment system included ease of use particularly surrounding cell phone-based apps, quality of actionable information, and participant buy-in. Barriers to use included work-flow disruption, and perception that the results would not outweigh the effort.
Conclusions:
Participants felt there was value in improving surgical assessment and feedback paradigms to improve assessment accuracy and provide actionable feedback. Skepticism surrounding potential assessment and feedback systems will require thoughtful implementation to be successful.
