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This is the first report of cross-institutional surgical coaching for the continuous professional development of practicing surgeons, demonstrating perceived value among participants, as well as logistical challenges for implementing this evidence-based program. Future research is necessary to evaluate the impact of coaching on practice change and patient outcomes.

Peer-nominated surgical coaches were provided with training on abstract concepts that underlie effective coaching practices in other fields. By identifying the strategies used by peer surgical coaches to operationalize these concepts, empirically based strategies to inform other surgical coaching programs are provided.

eer surgical coaching is an approach to continuous professional development that uses adult learning theory to support a surgeon's individual performance improvement. [1][2][3][4] In peer surgical coaching, a practicing surgeon is paired with a trained surgeon coach. This partnership uses coaching sessions for collaborative analysis and constructive feedback to improve technical, cognitive, interpersonal, and stress management skills through goal setting and action planning. These coaching interactions provide an evidencebased approach to practice change. [1][2][3][4] The success of this approach to continuous professional development requires adherence to coaching principles. However, to our knowledge, there is currently no tool to assess a surgical coach's performance during a coaching session as mea-sured by adherence to coaching principles. Without an instrument to evaluate a surgical coach, it is challenging to determine the quality of a coaching session or provide formative feedback to coaches on their performance. We aimed to fill this gap by developing and evaluating the validity of the Wisconsin Surgical Coaching Rubric (WiSCoR), a novel tool for assessing coach performance during a single peer surgical coaching session. MethodsBuilding off the Wisconsin Surgical Coaching Program's (WSCP) framework, core competencies for surgical coaching were IMPORTANCE Surgical coaching continues to gain momentum as an innovative method for continuous professional development. A tool to measure the performance of a surgical coach is needed to provide formative feedback to coaches for continued skill development and to assess the fidelity of a coaching intervention for future research and dissemination.OBJECTIVE To evaluate the validity of the Wisconsin Surgical Coaching Rubric (WiSCoR), a novel tool to assess the performance of a peer surgical coach.DESIGN, SETTING, AND PARTICIPANTS Surgical coaching sessions from November 2014 through February 2018 conducted by 2 statewide peer surgical coaching programs were audio recorded and transcribed. Twelve raters used WiSCoR to rate the performance of the surgical coach for each session. The study included peer surgical coaches in the Wisconsin Surgical Coaching Program (n = 8) and the Michigan Bariatric Surgery Collaborative coaching program (n = 15). The data were analyzed in 2019. INTERVENTIONS OR EXPOSURESUse of WiSCoR to rate peer surgical coaching sessions.MAIN OUTCOMES AND MEASURES There were 282 WiSCoR ratings from the 106 coaching sessions included in the study. WiSCoR was evaluated using a framework, including inter-rater reliability assessed with Gwet weighted agreement coefficent. Descriptive statistics of WiSCoR were calculated.RESULTS Eight coaches (35%) and 11 coachees (29%) were from the Wisconsin Surgical Program and 15 coaches (65%) and 27 coachees (71%) were from the Michigan Bariatric Surgery Collaborative. The validity of WiSCoR is supported by high interrater reliability (Gwet weighted agreement coefficient, 0.87) as well as a weakly positive correlation ...

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