Exploring a New Methodological Approach for Capturing the 'Slowing Down' Moments of Operative Practice

• Main Author: St-Martin, Laurent Eskandar
• Other Authors: Moulton, Carol-anne
• Language: en_ca
• Published: 2014
• Subjects: surgical education; expertise; judgment; 0350; 0564
• Online Access: http://hdl.handle.net/1807/44059

The phenomenon of 'slowing down' in response to important cues in the operative field is proposed as a hallmark of expert surgical judgment. As part of a larger program of research, the purpose of this study was to explore a methodology for capturing 'slowing down' moments using a standardised task. Edited videos of 6 laparoscopic cholecystectomies were shown to 10 expert surgeons (>250 laparoscopic cholecystectomies completed). Participants were asked to think aloud while watching them as if observing each procedure in the operating room. Each session was audiotaped and transcribed. Many examples of 'slowing down' moments were identified in the transcripts, including several categories that were previously uncharacterised or undescribed. A subset of 'slowing down' moments was compared between participants. Many appeared to be inconsistent between expert surgeons, suggesting that with this methodology alone, formal teaching and assessment of the 'slowing down' phenomenon will be challenging.