Professional Development: Could Your Surgeons Use a Coach?

Tiger Woods works with a coach who tweaks his near-perfect swing. Stefani Germanotta takes voice lessons to be Lady Gaga. Glenn Close receives professional training to turn in Oscar-worthy performances year after year. Tiger, Gaga and Glenn are all elite performers, but still rely on expert advice to remain at the top of their chosen professions. Shouldn’t surgeons be coached on how they can perform better, safer surgery, especially when the stakes are much higher than sports and entertainment?

“Surgeons receive incredible amounts of training in medical school and throughout their residencies, but their skills could plateau after they’ve been operating independently for a number of years,” says Jason Pradarelli, MD, a general surgery resident at Brigham and Women’s Hospital in Boston, Mass., who advocates for peer or expert surgeons to coach colleagues on how to improve their surgical techniques or professionalism. “But it’s rare for experienced surgeons to invite another surgeon into the OR to observe them operating and provide feedback about their performances.”

Coaching — across all types of careers — is being viewed as a more appealing and acceptable form of professional development. There’s still cultural resistance to the idea in surgery, however, partly because some surgeons cling to the antiquated belief that they’re infallible leaders of the OR. Others might simply believe they don’t need to improve upon already successful careers.

All surgeons, regardless of their skill level and experience, can benefit from listening to constructive criticism from trusted outside observers. “Even top-performing surgeons stand a chance to get better throughout a really long career by having a coach,” says Dr. Pradarelli.

The best surgeon coaching programs are:

• Learning opportunities. Coaching interactions are non-punitive teaching moments for surgeons of all areas of expertise. Access to a coach should be offered in a non-threatening way that doesn’t single out low performers. Surgeons must be able to view coaching as a way to advance their careers without interfering with their autonomy and professional expertise. “Effective coaching programs align with these cultural priorities,” says Dr. Pradarelli.
• Based on respect. One of the most important aspects of the coach-coachee relationship is respecting the professionalism of the surgeon who seeks help. “We don’t yet know who makes an ideal coach or an ideal pair,” says Dr. Pradarelli. “But based on other industries in which coaches have had success, and from expert opinions in surgical coaching literature, mutual trust and respect, and establishing a rapport, are very important factors in a successful coaching relationship.”
• Focused on individual needs. Surgeons can rely on peers to learn new surgical techniques or how to operate with new technologies, but mastering nontechnical skills are just as important for safe patient care and good outcomes.

“Surgeons are recognizing that they haven’t received formal training in how to best communicate decisions to surgical team members, leadership skills, teamwork behaviors and situational awareness about what’s happening outside of the surgical field,” says Dr. Pradarelli. “They might now ask for feedback on how they’re communicating with the anesthesia provider and nursing team throughout the case.”

Unlike continuing education courses offered online or at conferences, coaching is personalized training focusing on what individual surgeons want to improve upon, says Adrienne Faerber, PhD, executive director of the Academy for Surgical Coaching ( surgicalcoaching.org) in Madison, Wis., a non-profit organization that trains surgeons how to coach — which requires a different skill set than teaching — and matches surgeons with appropriate coaches from across the country. A4SC also designs custom coaching programs for professional societies and healthcare systems.

Dr. Faerber sees surgeons becoming more aware of their well-being outside of the OR and working with coaches to improve their mental health and stress management.

“The tension and time commitment of a career in surgery can put a lot strain on their personal lives,” explains Dr. Faerber. “Working with a coach gives them the ability to step back and gain a better perspective, so they’re not just skilled providers. Happy surgeons are better teammates and better people.” OSM