Surgical Endoscopy

, Volume 32, Issue 10, pp 4183–4190 | Cite as

Examining the impact of surgical coaching on trainee physiologic response and basic skill acquisition

  • Matthew D. Timberlake
  • Dimitrios Stefanidis
  • Aimee K. GardnerEmail author



We examined how problem-solving coaching impacts trainee skill acquisition and physiologic stress as well as how trainee sensitivity to feedback, known as self-monitoring ability, impacts coaching effectiveness.


Medical students completed a pre-training demographics questionnaire, a 12-item self-monitoring ability scale (1 = always false, 5 = always true), and baseline FLS Task 5 with physiologic sensors. After watching a laparoscopic suturing instructional video, students practiced the task for 30 min, either with a surgical coach, or alone, depending on condition. The coach logged frequency of coaching behaviors according to a task-specific coaching script. Trainees then completed FLS Task 5 with physiologic sensors, a post-training questionnaire, and a 12-item coaching quality evaluation (1 = poor, 5 = very good).


Twenty-four students (age 24.5 ± 1.4; 54% men; 58% MS4) participated in the study. All were fairly high self-monitors (3.8 ± 0.76). No differences in baseline suturing skills between the groups emerged. Improvement in the coaching group‘s suturing (N = 12; 285.0 ± 79.9) was significantly higher than the control group (N = 12; 200.9 ± 110.3). One measure of physiologic stress (rMSSD) was significantly higher in the coaching group. Trainees who received more coaching demonstrated larger improvements (r = 0.7, p < 0.05). Overall ,perceived quality of the coaching relationship was high (4.4 ± 0.6). There was no correlation between trainee self-monitoring ability and skill improvement.


This work suggests that coaching may increase heart rate variability of trainees, indicating coping well with training. Trainee disposition toward feedback did not play a role in this relationship.


Coaching Stress Physiologic stress Eustress Self-monitoring 



Operating room


Heart rate


Heart rate variability


Respiration frequency





We thank Ibrahim I. Jabbour, MD for serving as the coach in this study.


The study was funded through a departmental educational research grant from the University of Texas Southwestern Department of Surgery to A.K.G.

Compliance with ethical standards


Dr. Gardner has ownership interest in SurgWise Consulting, LLC. Dr. Timberlake, and Dr. Stefanidis has no relevant conflict of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Matthew D. Timberlake
    • 1
  • Dimitrios Stefanidis
    • 2
  • Aimee K. Gardner
    • 3
    Email author
  1. 1.Department of UrologyUniversity of Texas Southwestern Medical CenterDallasUSA
  2. 2.Department of SurgeryIndiana UniversityIndianapolisUSA
  3. 3.Department of Surgery, School of Allied Health SciencesBaylor College of MedicineHoustonUSA

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