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Abstract：
Surgical coaching is an emerging concept of education and collaboration to improve surgical performance. Surgical education in low-resource settings remains a challenge because of confounding barriers of access, resources, and sustainability. No formal assessments of coaching as a means to improve surgical quality in low- or middle-income countries (LMICs) exist. The purpose of this review is to explore if surgical coaching could serve as an effective method of fostering continued education and advancement of surgical skills in low-resource settings.
We conducted a systematic literature search in July 2018. Included studies were peer-reviewed and met preestablished study criteria. Studies must have assessed surgical coaching, specifically defined as a means to establish continuous professional growth of trainees and practicing surgeons.
Of 2189 articles, 175 were selected for full-text analysis, 23 met inclusion criteria for analysis, 13 of these 23 articles evaluated coaching of trainees, 10 articles assessed coaching surgeons in established careers. 18 of the 23 articles discussed skill acquisition, 4 of which assessed nontechnical skills alone, and 14 assessed technical skills or both technical and nontechnical skills. Remote or cross-institutional coaching was explored in 8 of the 23 studies. None of the studies discussed or evaluated coaching in LMICs.
Coaching is a method of teaching surgeons at multiple stages of a career. The explored advantages of surgical coaching may be applied to continuous performance improvement and collaboration with surgeons in LMICs. Furthermore, coaching may aid in advancement of the well-established Lancet Global Surgery Indicators, improving surgical capacity and quality in LMICs.
We conducted a systematic literature search in July 2018. Included studies were peer-reviewed and met preestablished study criteria. Studies must have assessed surgical coaching, specifically defined as a means to establish continuous professional growth of trainees and practicing surgeons.
Of 2189 articles, 175 were selected for full-text analysis, 23 met inclusion criteria for analysis, 13 of these 23 articles evaluated coaching of trainees, 10 articles assessed coaching surgeons in established careers. 18 of the 23 articles discussed skill acquisition, 4 of which assessed nontechnical skills alone, and 14 assessed technical skills or both technical and nontechnical skills. Remote or cross-institutional coaching was explored in 8 of the 23 studies. None of the studies discussed or evaluated coaching in LMICs.
Coaching is a method of teaching surgeons at multiple stages of a career. The explored advantages of surgical coaching may be applied to continuous performance improvement and collaboration with surgeons in LMICs. Furthermore, coaching may aid in advancement of the well-established Lancet Global Surgery Indicators, improving surgical capacity and quality in LMICs.
摘要：
手术指导是一种新兴的教育和合作概念，以提高手术性能。低资源环境中的外科教育仍然是一个挑战，因为入学障碍令人困惑，资源,和可持续性。在低收入或中等收入国家（LMICs），没有正式的培训评估作为提高手术质量的手段。这篇评论的目的是探讨手术指导是否可以作为在低资源环境中促进继续教育和提高手术技能的有效方法。
我们在2018年7月进行了系统的文献检索。纳入的研究经过同行评审，符合预设的研究标准。研究必须评估手术指导，专门定义为建立学员和执业外科医生持续专业成长的手段。
在2189篇文章中，选择175个进行全文分析，23符合纳入分析标准，这23篇文章中有13篇文章评估了学员的教练，10篇文章评估了既定职业中的教练外科医生。在23篇文章中，有18篇文章讨论了技能习得，其中4项单独评估非技术技能，和14评估技术技能或技术和非技术技能。在23项研究中，有8项研究探索了远程或跨机构指导。没有一项研究讨论或评估了LMIC的教练。
教练是在职业生涯的多个阶段教授外科医生的一种方法。手术指导的探索优势可应用于持续的绩效改进以及与LMIC外科医生的合作。此外，教练可能有助于推进完善的柳叶刀全球手术指标，提高LMIC的手术能力和质量。
我们在2018年7月进行了系统的文献检索。纳入的研究经过同行评审，符合预设的研究标准。研究必须评估手术指导，专门定义为建立学员和执业外科医生持续专业成长的手段。
在2189篇文章中，选择175个进行全文分析，23符合纳入分析标准，这23篇文章中有13篇文章评估了学员的教练，10篇文章评估了既定职业中的教练外科医生。在23篇文章中，有18篇文章讨论了技能习得，其中4项单独评估非技术技能，和14评估技术技能或技术和非技术技能。在23项研究中，有8项研究探索了远程或跨机构指导。没有一项研究讨论或评估了LMIC的教练。
教练是在职业生涯的多个阶段教授外科医生的一种方法。手术指导的探索优势可应用于持续的绩效改进以及与LMIC外科医生的合作。此外，教练可能有助于推进完善的柳叶刀全球手术指标，提高LMIC的手术能力和质量。
