A taxonomy of surgeons' guiding behaviors in the operating room

BackgroundThis study explores the nature and the intention of attending surgeons' guiding behaviors performed in the operating room (OR) in order to build taxonomy of OR guiding behavior.MethodsNine attending surgeons and 8 surgical residents were invited to observe 8 prerecorded surgical cases from 4 common procedures and completed semistructured interviews. All video-based observations were videotaped. Thematic analysis was applied to identify surgeons' OR guiding behavior.ResultsSeven hundred eighty minutes of video-based observations with interviews were conducted. Sixteen types of OR guiding behaviors in 3 intention-based categories were identified: 3 of the 16 was “teaching” (18.75%), 8 of the 16 was “directing” (50%), and 5 of the 16 was “assisting” (31.25%).ConclusionsSurgeons' OR guiding behaviors were grounded in 3 behavioral intentions: teaching, directing, and assisting. This taxonomy of OR guiding behavior can be used as a basis for developing OR guiding strategy to improve residents' intraoperative competency, autonomy, and independence.