As a resident, Dr. Rapoport found it less effective when attendings provided feedback by comparing her and her co-residents’ performances to each other rather than their own, individual progress. “Now that I’m an attending teaching my own residents, I keep this in mind and aim to provide each resident I work with feedback specific to their own performance over time,” she said. “I hope this sets them up to succeed the next time they face the same clinical decision or scenario.”
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January 2025Karen Appold is an award-winning journalist based in Pennsylvania.
How to Provide Instant Feedback During Surgery
Teaching surgery is challenging, especially when you’re watching a resident operate and can’t tell whether their next move will be precarious or the same one you would choose, said Sarah K. Rapoport, MD, assistant professor in the department of otolaryngology–head and neck surgery at Georgetown University Hospital and the Washington, D.C. Veterans Affairs Medical Center in Washington, D.C.
Asking a resident to share their thought process with you out loud as they’re operating, especially at more critical points in a case when your inclination might be to take the case over from them, can allow you to guide a trainee through decision making they need to learn but may not often have the chance to try, Dr Rapoport said. It’s not always possible, but it can be worthwhile when it is.
“I use this technique when I’m teaching a resident in the operating room and I want to prolong the period when they’re operating before I have to take over,” Dr. Rapoport said. “By asking residents to think aloud as they operate, I can redirect them when I think they should take different steps, and I can grant them prolonged periods of autonomy if the operative techniques they’re planning to demonstrate align with correct intra-operative decisions.”
“Knowing a resident’s thought process behind their decisions during a case can help me provide specific feedback, particularly when I was expecting a different thought process,” she continued. “This can also allow me to commend learners for thinking through a circumstance appropriately.”
Oftentimes, giving a trainee the chance to speak first about their thought process during a learning experience can lower any tensions they may have around receiving feedback, Dr. Rapoport said. It can also provide an instructor with an opportunity to listen and understand their trainee better—which can help to frame feedback in a more relatable way.