One-third of Australians live in rural and remote areas, according to the Australian Institute of Health and Welfare. On average, residents of these communities have a higher incidence of disease and injury and poorer health outcomes. Research shows that improvements in non-technical skills such as communication, leadership and decision-making lead to fewer adverse events in surgery and better patient outcomes.
Surgeons who treat rural and remote Australians need to deliver care that is determined by the needs, circumstances and facilities of the communities they serve. Often these surgeons are urban surgeons who visit rural areas acting as mentors, supervisors and role models for rural surgical trainees. New tools such as videoconferencing and video-based coaching can optimise continuing education for surgeons in rural hospitals.
The Royal Australasian College of Surgeons (RACS) has launched a study to evaluate video-based coaching to improve the non-technical skills of surgeons in rural settings. The President of RACS, Associate Professor Kerin Fielding, is particularly excited about what this project can bring to rural surgery: ‘This innovation has the potential to link the expertise from both rural and metropolitan settings, increase opportunity for personal development and, in the future, be used to create a greater teaching and learning environment for rural surgical trainees.’
Video-based coaching for surgeons to improve their non-technical skills is an area of great interest. It represents an innovative and low-cost alternative for training surgeons in developing these skills. Video-based coaching allows surgeons and their peers to review their own behaviours, examine non-technical aspects of their performance and create action plans for improvement through reflection and feedback. This style of coaching benefits both trainee surgeons and those already in rural practice.
In the RACS study, videos are taken of surgical consultants during outpatient consultations and ward rounds, and during a general surgery operation. The recordings are used to examine the surgeon’s interactions with patients and medical staff. An expert surgical coach uses the video to provide feedback and suggest ways to improve communication, decision-making, leadership and teamwork. After a second round of recording and coaching it is hoped that improvements seen in these areas can be imparted to surgeons in the rural setting.
Filming of participants at Port Augusta and Mount Gambier hospitals has already commenced. The project will begin at Port Lincoln Hospital shortly.
The study team will evaluate the value of video-based coaching in rural settings. Video-based coaching is potentially cost-effective and feasible in rural environments where time constraints, scheduling and location present barriers to personal coaching. Positive findings will allow the expansion of the study into a rural surgical coaching program to provide enhanced training opportunities for those in remote locations where training resources are limited.
The RACS study aligns with the objectives of RACS to help improve the health and wellbeing of the 7 million people living in rural, regional and remote Australia. There is a need for more surgeons to work and take up permanent residence in our rural areas to improve access to effective treatments for residents, as well as to adequately support surgeons to provide an optimal teaching environment for surgical trainees in the rural setting.
Recruitment for the study is still open. Funding is provided by the Australian Government Department of Health and Aged Care’s Specialist Training Program