Abstract：
BACKGROUND: There is increasing attention on the coaching of surgeons and trainees to improve performance but no comprehensive review on this topic. The purpose of this review is to summarize the quantity and the quality of studies involving surgical coaching methods and their effectiveness.
METHODS: We performed a systematic literature search through PubMed and PsychINFO by using predefined inclusion criteria. Evidence for main outcome categories was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and the Medical Education Research Study Quality Instrument (MERSQI).
RESULTS: Of a total 3,063 articles, 23 met our inclusion criteria; 4 randomized controlled trials and 19 observational studies. We categorized the articles into 4 groups on the basis of the outcome studied: perception, attitude and opinion; technical skills; nontechnical skills; and performance measures. Overall strength of evidence for each outcome groups was as follows: Perception, attitude, and opinion (Grading of Recommendations Assessment, Development, and Evaluation: Very Low, Medical Education Research Study Quality Instrument [MERSQI]: 10); technical skills (randomized controlled trials: High, 13.1; Observation studies: Very Low, 11.5); nontechnical skills (Very Low, 12.4) and performance measures (Very Low, 13.6). Simulation was the most used setting for coaching; more than half of the studies deployed an experienced surgeon as a coach and showed that coaching was effective.
CONCLUSIONS: Surgical coaching interventions have a positive impact on learners\' perception and attitudes, their technical and nontechnical skills, and performance measures. Evidence of impact on patient outcomes was limited, and the quality of research studies was variable. Despite this, our systematic review of different coaching interventions will benefit future coaching strategies and implementation to enhance operative performance.
METHODS: We performed a systematic literature search through PubMed and PsychINFO by using predefined inclusion criteria. Evidence for main outcome categories was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and the Medical Education Research Study Quality Instrument (MERSQI).
RESULTS: Of a total 3,063 articles, 23 met our inclusion criteria; 4 randomized controlled trials and 19 observational studies. We categorized the articles into 4 groups on the basis of the outcome studied: perception, attitude and opinion; technical skills; nontechnical skills; and performance measures. Overall strength of evidence for each outcome groups was as follows: Perception, attitude, and opinion (Grading of Recommendations Assessment, Development, and Evaluation: Very Low, Medical Education Research Study Quality Instrument [MERSQI]: 10); technical skills (randomized controlled trials: High, 13.1; Observation studies: Very Low, 11.5); nontechnical skills (Very Low, 12.4) and performance measures (Very Low, 13.6). Simulation was the most used setting for coaching; more than half of the studies deployed an experienced surgeon as a coach and showed that coaching was effective.
CONCLUSIONS: Surgical coaching interventions have a positive impact on learners\' perception and attitudes, their technical and nontechnical skills, and performance measures. Evidence of impact on patient outcomes was limited, and the quality of research studies was variable. Despite this, our systematic review of different coaching interventions will benefit future coaching strategies and implementation to enhance operative performance.
摘要：
背景：对外科医生和受训者的指导以提高绩效的关注越来越多，但对此主题没有全面的回顾。这篇综述的目的是总结涉及手术指导方法及其有效性的研究的数量和质量。
方法：我们通过使用预定义的纳入标准，通过PubMed和PsychINFO进行了系统的文献检索。主要结果类别的证据通过建议分级评估进行了评估，发展,和评估（等级）系统和医学教育研究质量工具（MERSQI）。
结果：在总共3063篇文章中，23项符合纳入标准；4项随机对照试验和19项观察性研究。我们根据研究的结果将文章分为4组：感知，态度和意见；技术技能；非技术技能；和绩效指标。每个结果组的总体证据强度如下：感知，态度,和意见(建议评估分级，发展,和评价：非常低，医学教育研究研究质量仪器[MERSQI]：10）；技术技能（随机对照试验：高，13.1；观察研究：非常低，11.5)；非技术技能(非常低，12.4)和绩效指标(非常低，13.6)。模拟是最常用的教练设置;超过一半的研究部署经验丰富的外科医生作为教练，并表明教练是有效的。
结论：手术指导干预对学习者的感知和态度有积极影响，他们的技术和非技术技能，和绩效指标。对患者预后影响的证据有限，研究的质量是可变的。尽管如此,我们对不同教练干预措施的系统回顾将有利于未来的教练策略和实施，以提高手术绩效。
方法：我们通过使用预定义的纳入标准，通过PubMed和PsychINFO进行了系统的文献检索。主要结果类别的证据通过建议分级评估进行了评估，发展,和评估（等级）系统和医学教育研究质量工具（MERSQI）。
结果：在总共3063篇文章中，23项符合纳入标准；4项随机对照试验和19项观察性研究。我们根据研究的结果将文章分为4组：感知，态度和意见；技术技能；非技术技能；和绩效指标。每个结果组的总体证据强度如下：感知，态度,和意见(建议评估分级，发展,和评价：非常低，医学教育研究研究质量仪器[MERSQI]：10）；技术技能（随机对照试验：高，13.1；观察研究：非常低，11.5)；非技术技能(非常低，12.4)和绩效指标(非常低，13.6)。模拟是最常用的教练设置;超过一半的研究部署经验丰富的外科医生作为教练，并表明教练是有效的。
结论：手术指导干预对学习者的感知和态度有积极影响，他们的技术和非技术技能，和绩效指标。对患者预后影响的证据有限，研究的质量是可变的。尽管如此,我们对不同教练干预措施的系统回顾将有利于未来的教练策略和实施，以提高手术绩效。
