Perceptions and observations of coaching
A.P.B. Alken, E.C.T.H. Tan, J-M. Luursema, C.R.M.G. Fluit, H. van Goor
Radboud University Nijmegen Medical Center, the Netherlands
• The Definitive Surgical Trauma Care course Master class for trauma management
• Learning objective Treatment of life-threatening injuries by operating team
• Six complex scenarios Abdominal and thoracic trauma
• Live tissue training highly realistic
• Coaching by faculty
Introduction – the DSTC course
1. How did trainees and faculty perceive the
coaching?
2. How congruent are these perceptions
with observed findings?
Study purpose
• Faculty self reports vs. trainee questionnaires Faculty report higher satisfaction 1,2
• Perceptions vs structured observations No research
Background – prior research
1. Levinson et al. J Grad Med Educ 2010;2(1):31-36.2. Yarris et al. Acad Emerg Med 2009;16(2):S76–81..
• DSTC training 11 teams; per team: 1 faculty and 2 trainees
• Faculty self reports and trainee questionnaires 12 items 1 – 6 (absolutely not/never - absolutely yes/all the time)
Example:
“I would describe the feedback as being focused on corrections”
“The coaching was directed at the way trainees communicated in the team”
• Observations 45 minutes of identical scenarios
Methods
• Observational instrument 3
Methods – observational instrument
Technical skills Communication skills
Team skills
Reinforced Reinforced Reinforced
Exp
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3. Presented at ASE congress 2012
Corrective feedback Positive feedback Instruction
Reinforced Reinforced Reinforced
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all
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how
Reinforced Reinforced Reinforced
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Reinforced Reinforced Reinforced
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Reinforced Reinforced Reinforced
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Reinforced Reinforced Reinforced
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all
How
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why
Exp
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Reinforced Reinforced Reinforced
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Not
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Reinforced Reinforced Reinforced
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Reinforced Reinforced Reinforced
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Reinforced Reinforced Reinforced
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why
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Not
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Reinforced Reinforced Reinforced
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Reinforced Reinforced Reinforced
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How
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Reinforced Reinforced Reinforced
Not
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why
• 7 of 12 items matched with observation
1. Corrective feedback
2. Positive feedback
3. Technical skills
4. Communication skills
5. Team skills
6. Explanations why correct
7. Explanations why incorrect
Methods – matching variables
• Comparison
• Faculty perceptions – trainee perceptions
• Faculty perceptions – independent observations
• Trainee perceptions – independent observations
• Statistical analysis Mean and median scores Wilcoxon signed rank tests Correlations
Methods - statistics
• Faculty vs. trainees
Results - perceptions
Faculty means Trainee means
Corrective feedback 4.6 5.1*
Positive feedback 5.0* 4.4
Coaching timed well 4.4 5.3*
Reinforcements why correct 4.7 5.2*
Reinforcements why incorrect 3.9 4.9*
• Perceptions vs 45 min observations Mean coaching activities per faculty: 30 times
Faculty vs. observations: coaching on communication skills: ρ = .6
Results – perceptions vs. observations
Faculty ratings6-point scale
Trainee ratings6-point scale
Observed count
Corrective feedback 4.6 5.1 2
Positive feedback 5.0 4.4 2
Instructions 26
Technical skills 4.6 4.8 28
Communication skills 4.4 4.7 2
Team skills 3.8 4.6 0.3
Expl. why correct 4.6 5.2 2
Expl. why incorrect 3.9 4.9 0
Not reinforced or how 28
• Differences in coaching perceptions faculty and trainees
• Discrepancy between observation and perception in type of coaching and level of reinforcement
Conclusions
• Overall satisfaction may have contributed 4
• Faculty rate to the ideal level 5
• Perception questionnaires not always effective
Discussion
4. Palter et al. Surg Endosc 2010; 24: 2830-2834.5. Moorthy K et al. Am J Surg 2006;192:114-118.
Thank you!Thank you!
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