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

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.