Dorotea Mutabdzic, MD, MEd; Maria Mylopoulos, PhD; M Lucas Murnaghan, MD, MEd, FRCSC; Priyanka Patel, MSc; Nathan Zilbert, MD, MEd; Natashia Seemann, MD; Glenn Regehr, PhD; Carol-Anne Moulton, MBBS, PhD, MEd.

Evidence suggests that coaching might be an effective strategy to facilitate the ongoing development of expertise after formal surgical training. For this to be successful, surgeons’ cultural beliefs and attitudes towards coaching need to be more completely understood.

A Constructivist grounded theory study was conducted to explore cultural beliefs and attitudes toward coaching. Semi-structured interviews with 16 surgeons from the University of Toronto were sampled from different experience levels. Data was coded iteratively until emerging theoretical constructs were saturated and 3 broad categories of expertise, assessment, and surgeon image emerged.

Experienced surgeons believed that expertise is developed individually through self-assessment, and that external assessment implies need for remediation. Less experienced surgeons were more open to external assessment. Both groups expressed interest in coaching if it becomes widespread practice but were concerned that requesting coaching would be misperceived as admitting incompetence.

Although most participant surgeons could see the benefit of coaching, they anticipated that coaching would not be accepted in the current surgical culture. The cultural practices, of independent development and self-assessment, conflict with the collaborative development and external assessment proposed by coaching. Seeking coaching is seen as inconsistent with a surgeon identity that emphasized competence and confidence. Current cultural beliefs about the development of expertise, assessment, and surgeon identity may make the successful application of coaching in surgery a challenge.

Supported by the Canadian Medical Protective Association Grant Program