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Surgery Attendings' Autonomy-Supportive and Controlling Coaching in the Operating Room.

Angela G Atkinson1, Jennifer A H Becker2, Ross E Willis1

  • 1Department of General Surgery, University of Texas Health at San Antonio, San Antonio, Texas.

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|January 16, 2026
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Summary

Surgical coaching can be both autonomy-supportive and controlling. Key themes include surgeon identity, evolving goals, and word choice, impacting resident perceptions during operations.

Keywords:
autonomy-supportivecontrollingfaculty developmentintraoperative teachingsurgical coachingsurgical education

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Area of Science:

  • Medical Education
  • Surgical Training
  • Qualitative Research

Background:

  • Effective surgical coaching is crucial for resident development.
  • Understanding the nuances between autonomy-supportive and controlling coaching is essential for optimizing learning environments.

Purpose of the Study:

  • To identify themes differentiating autonomy-supportive from controlling surgical coaching.
  • To compare attending and resident perceptions of surgical coaching behaviors.

Main Methods:

  • Descriptive, exploratory case series of 18 operating room procedures.
  • Reflexive thematic analysis of attending-resident interactions.
  • Quantitative analysis of postoperative survey responses on perceived coaching behaviors.

Main Results:

  • Coaching behaviors varied, influenced by surgeon identity, evolving intraoperative goals, and word choice.
  • Autonomy-supportive coaching is possible even in high-stakes situations through cognitive engagement and scaffolding.
  • No significant difference was found in the perceived frequency of autonomy-supportive behaviors across categories.

Conclusions:

  • Attending surgeons demonstrate both autonomy-supportive and controlling coaching styles in the operating room.
  • Further research is needed to identify optimal coaching strategies and provide recommendations.