| Authors: |
Norton, Joel1,2,3 (AUTHOR) Joel.norton@nhs.scot, Ambler, Olivia4 (AUTHOR), Lillemoe, Heather5,6 (AUTHOR), Tambyraja, Andrew1,2,3 (AUTHOR), Yule, Steven1,3 (AUTHOR) |
| Abstract: |
Background: The preoperative educational briefing is a focused discussion encompassing trainee goal setting and operative strategy. How to effectively deliver the educational briefing and the associated benefits to surgical learning and performance remain unclear. The aim of this study was to extract common themes from briefing templates, examine the impact on surgical education and performance metrics, and propose an evidence-based, structured framework for future implementation. Methods: The MEDLINE, Embase, PubMed, and Web of Science databases were systematically searched for relevant studies that were published between database inception and 15 May 2024. Eligible studies involved surgical trainees and implemented educational briefing in the operating room environment. Results were thematically analysed, identifying 12 outcome measures, organized within Kirkpatrick's model of learning evaluation. Results: Some 7174 studies were screened, of which 20 met the inclusion criteria. A total of 17 studies compared pre- and post-educational briefing implementation participant surveys focusing on surgical education and performance metrics. A total of 95 statistically significant results were identified, of which 93 demonstrated improvement after the introduction of educational briefing. Benefit was identified in 7 of 7 studies investigating reaction (for example briefing impact), 11 of 13 studies examining learning (for example intraoperative teaching), 12 of 14 studies investigating behaviour (for example goal setting), and 6 of 9 studies examining surgical results (for example trainee autonomy). Thematic analysis of briefing templates demonstrated four key themes, forming the proposed 'Goals, Autonomy, Preparation, and Strategy' ('GAPS') framework for standardized preoperative educational briefing. Conclusion: The implementation of structured preoperative educational briefing significantly improves surgical education and performance outcomes. The 'Goals, Autonomy, Preparation, and Strategy' framework facilitates a deliberate, evidence-based approach to educational briefing for implementation across surgical specialties and healthcare systems. What is the available evidence for how to effectively conduct a preoperative educational briefing and what are the associated benefits to surgical education and performance? In this systematic review, implementation of educational briefing was associated with improvement in 12 surgical learning and performance outcome measures (for example goal setting, feedback, and autonomy). Four recurrent themes identified from briefing templates formed the proposed 'Goals, Autonomy, Preparation, and Strategy' ('GAPS') framework for evidence-based, structured preoperative educational briefing. Lay Summary: This study looked at the impact of structured educational dialogue between senior surgeons and surgical trainees (known as preoperative educational briefing) on trainee learning and performance during operations. To do this, the researchers found all studies (20 in total) where a preoperative educational briefing was put in place. They found that, after an educational briefing was used, improvement was found in things like trainee preparation for operations, communication between team members, and how much of the procedure the trainee could do without supervisor help. The researchers then looked at all known versions of preoperative educational briefings to see what the most common topics of discussion were. They found four main examples: goal setting (does the trainee know what part(s) of the operation they want to do); autonomy (how much help does the trainee need to do part(s) of the operation); preparation (has the trainee properly reviewed the patient's medical records and scans); and strategy (the tactics to ensure the operation goes smoothly and the trainee achieves their learning goal(s)). These examples were put together to form the new 'Goals, Autonomy, Preparation, and Strategy' ('GAPS') framework for structured preoperative educational briefing, based on the findings of this study. The 'Goals, Autonomy, Preparation, and Strategy' framework can now be used by surgeons around the world to improve surgical training. [ABSTRACT FROM AUTHOR] |
