• Thomas J Sitzman, Raymond W Tse, Alexander C Allori, David M Fisher, Thomas D Samson, Stephen P Beals, Damir B Matic, Jeffrey R Marcus, Daniel H Grossoehme, and Maria T Britto.
• From the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
• Plast. Reconstr. Surg. 2020 Jul 1; 146 (1): 144-153.

BackgroundImproving surgeons' technical performance may reduce their frequency of postoperative complications. The authors conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgical coaching on technical performance among surgeons performing cleft palate repair, in advance of a future effectiveness trial.MethodsA nonrandomized, two-arm, unblinded pilot trial enrolled surgeons performing cleft palate repair. Participants completed a baseline audit of fistula incidence. Participants with a fistula incidence above the median were allocated to an intensive feedback intervention that included selecting a peer surgical coach, observing the coach perform palate repair, reviewing operative video of their own surgical technique with the coach, and proposing and implementing changes in their technique. All others were allocated to simple feedback (receiving audit results). Outcomes assessed were proportion of surgeons completing the baseline audit, disclosing their fistula incidence to peers, and completing the feedback intervention.ResultsSeven surgeons enrolled in the trial. All seven completed the baseline audit and disclosed their fistula incidence to other participants. The median baseline fistula incidence was 0.4 percent (range, 0 to 10.5 percent). Two surgeons were unable to receive the feedback intervention. Of the five remaining surgeons, two were allocated to intensive feedback and three to simple feedback. All surgeons completed their assigned feedback intervention. Among surgeons receiving intensive feedback, fistula incidence was 5.9 percent at baseline and 0.0 percent following feedback (adjusted OR, 0.98; 95 percent CI, 0.44 to 2.17).ConclusionSurgeon-delivered audit and feedback incorporating peer coaching on technical performance was feasible for surgeons.

18 keywords...

hide…