Surgical Supervisor Feedback Affects Performance: A Blinded Randomized Study

Abstract

While performing a simple task of following: a suture while closing a surgical wound in a simulated environment, we hypothesized that negative reinforcement results in increased procedural errors, longer operating time and poorer trainee satisfaction. We aimed to measure the effect on participant performance and the perception of the instructor, following positive or negative supervisor feedback during the task. A blinded randomized study was conducted assessing positive and negative supervisor feedback styles on participant performance in a simulated operation room. Students performed the task twice, with a reflection in between the repeated task. We found that the change in procedure time between the two tasks was adversely affected by feedback style. Participants receiving negative feedback sought cues to improve. From this study, it was found that negative supervisor feedback has the potential to adversely affect elements of performance. Despite this, participants receiving negative feedback express a willingness to improve their performance by seeking cues from the supervisor.

Proctorship in Minimally Invasive Colorectal Surgery

“…This has led to supervisors having to focus more on the needs of the trainees and to ensure that they are rather guided to achieve competency than overburdened with the complexity of the task. 12 Ideally, a proctor is anyone who has a willingness to train a colleague in a skill or procedure they themselves are recognized as a master and have the right temperament to aide in the efficient transfer of theoretical knowledge and skill. The proctor should also effectively evaluate the clinical competence and document the learning progress.…”

Feedback in an Epidemic?

“…Furthermore, the appropriate learning environment helps trainees develop an improved perception of their current skills and plan for future learning requirements [11]. However, if the trainers try to save time by not giving feedback to their trainees, it can lead to a negative effect on their performance [12].…”

Feedback in the clinical setting

“…However, health professional educators, students and peers can find it difficult to learn from one and other through feedback practices [ 3 ]. Feedback practices are often unsustainable, and de-motivating for students [ 3 , 4 ]. The ability to assess and provide feedback is a learnt skill, requiring an appropriate level of training.…”

“… Lack of external feedback. Without external feedback, students may generate their own feedback - but, self-assessment is often wrong [ 4 ]. High performers tend to underestimate their own performance, and lower performers tend to overestimate [ 9 ].…”

“…Although provision of constructive feedback detailing both positive and negative aspects of the learner’s performance can be time consuming and difficult, not giving feedback can have a substantial negative effect. If not relayed carefully, feedback can result in a deterioration in performance [ 4 , 21 ]. If handled poorly, feedback can also cause defensiveness and embarrassment to the learner.…”