C1 - 07: SURGEON COLLABORATION IN THE LEARNING AND IMPLEMENTATION OF NEW PROCEDURES
Shay Seth, MD1, Wade Gofton, MD, MEd1, Carol-anne Moulton, MBBS, PhD2, Timothy Wood, PhD1; 1University of Ottawa, 2University of Toronto
Purpose: Physicians regularly make changes in their practice to ensure they are providing high quality patient care. In surgery, this includes learning and safely implementing new skills, techniques and technologies. The process of adopting a new procedure is associated with risks to patients, surgeons and the healthcare system. Surgeons are responsible for identifying and addressing these risks prior to implementation of the new skill. This study explored the surgeon experience of learning and integrating a new procedure into practice and the strategies used to mitigate the associated risks.
Methods: A modified constructivist, grounded theory approach was utilized. Semi-structured interviews were conducted with eighteen purposively sampled surgeons and interpreted through constant comparative analysis. Emergent themes were identified and a conceptual framework was developed for understanding the surgeon experience associated with adopting and integrating a new procedure into practice.
Results: Despite representing various surgical specialties and hospitals, the participants described a similar approach to identifying and addressing the risks associated with the adoption of a new procedure. Collaborating with peers and mentors was cited as being a particularly important strategy for facilitating the implementation of a new skill. Surgeons characterized the direct support provided by a colleague or mentor during the learning process and in the operating room as an element that increased their comfort level. However, the process of arranging such collaborations was described as a hindrance to the process. Surgeons perceived policies related to licensure, insurance and hospital privileges as barriers to working with colleagues and mentors to safely implement new skills.
Conclusion: When going through the process of learning and implementing a new procedure, surgeons attempt to create an optimal learning and practice environment that maximizes patient safety. However, their efforts can be obstructed by the policies that govern the healthcare system. These policies, which are designed to ensure patient safety, have the unintended consequence of impeding surgeon learning, innovation and knowledge translation. This study highlights the need for surgeons and policy makers to work as partners in ensuring that surgeons receive the support that is needed for the safe implementation of new skills, techniques and technologies.