EP951 - Improving Surgical Performance through Elite Athlete Strategies: A Qualitative Study

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Purpose/Background: Despite the rapid emergence of coaching in surgery, there is conflicting data on how technical skill level impacts patient outcomes. This may be related to a concept described in elite sports. Rather than a focus on enhancing physical skills, which at an expert level provide only marginal gains, elite athletes focus on improvements in perceptual-cognitive skills (such as decision-making and anticipation) to optimize performance. In this context, we explored how surgeons use these skills when engaging in peer coaching.

Methods/Interventions: We analyzed video recordings and interviews with 13 surgeons over a 3-year peer coaching program focused on laparoscopic colon resections. Surgeons engaged in 10 3-hour coaching sessions in which participants gave formative feedback on videos submitted to the group. Using interaction analysis, we performed detailed video review, analysis of the transcribed interviews, and writing analytic memos from both data sources. We defined perceptual-cognitive skills as the ability to recognize and anticipate events, make decisions in both new and familiar situations, and integrate this knowledge with current abilities to make the appropriate action.

Results/Outcomes: We found that surgeons employed a number of perceptual-cognitive skills during formative feedback sessions both when explaining their surgical approaches and providing peer feedback. Specifically, surgeons demonstrated the ability to recognize and anticipate events during procedures, and they actively engaged in providing feedback to help peers improve these skills. Surgeons articulated intentions and strategies for integrating peer feedback into their decision-making processes through updating existing mental models. Notably, participants reported perceived improvements in their ability to access and deploy these cognitive skills, attributing improvements in their operative performance to the application of these perceptual-cognitive abilities.

Conclusion/Discussion: Surgeons rely on perceptual-cognitive skills in the operating room and are able to articulate these skills during formative peer feedback. Existing sport psychology literature indicates that these skills can be learned, improved, and transferred to others with deliberate practice, similar to physical or technical skills. Future work in surgical coaching should focus on enhancing cognitive skills to enhance performance beyond technical skill improvement alone.