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  • Surgical coaching is gaining popularity and meets the needs of current limitations in surgical training and assessment as well as continuous professional development for practicing clinicians.

  • There is evidence supporting feasibility and effectiveness of surgical coaching.

  • Limitations to surgical coaching include limited availability and time of coaches and coachees, affecting both scheduling and frequency of coaching sessions.

  • Automated surgical coaching could alleviate some limitations via automated skill assessment, automated video chaptering/indexing for quicker review, and automated targeted and actionable feedback or individualized learning plans.


Coaching is a common term used in sports, performing arts, and scholastic competitions; however, until recently, coaching was an alien concept to the profession of surgery. Unlike professional athletes who have a coach throughout their career, surgeons are their own masters once they “go pro” (ie, complete training and become independent practitioners). This does not mean, however, that surgeons are done mastering their skills once they enter independent practice. On the contrary, surgeons may find that more structured forms of engagement and continuous learning are needed once in practice because they may no longer have access to the constant supervision of a more senior surgeon.

In surgery, coaching has largely been defined by differentiating it from teaching, mentoring, and training.* For example, a coach may not be an expert in the field of the learner, whereas a mentor typically is. Coaching is not focused on imparting skills and knowledge, as is the case in teaching and training. In sports terminology, coaching is about taking your game to the next level. How do surgeons who have finished training and are (assumed) competent to perform their job become masters and then continuously develop their mastery? This question becomes even more important as research has shown correlations between the skill of attending surgeons and their patient outcomes.2 As lifelong learning and deliberate practice have gained importance as evidence-based strategies to improve performance, many studies have found a positive impact on performance from coaching in surgery.3

In this chapter, we will describe surgical coaching from an individual learning perspective (ie, a trainee’s or practicing surgeon’s skill development around procedures) and how advances in artificial intelligence (AI) could make coaching more accessible. Although coaching can be applied to team training and has been studied for broader surgical and medical care, we will focus on coaching for technical and nontechnical skills and automated coaching in the context of technical skills.

The Need for Surgical Coaching

Coaching in surgery is relevant to all stakeholders involved in the surgical care process, but patient outcome is one of the leading factors driving efforts in surgical coaching. Although a causal relationship has not been validated between coaching and patient outcomes, there is evidence demonstrating associations between coaching and skill acquisition/improvement4 and between operator skill level and patient outcomes....

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