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An experiential faculty orientation to set communication standards

members in deliberate teaching and delivery of feedback typically involves role-play based on fictitious scenarios in a low-stress environment. However, in daily practice feedback often takes place in a busy high-intensity context. Therefore, integrating training sessions on teaching and feedback into the setting of live operations could be very helpful for transfer into practice, but is rarely done. What was tried? As a faculty development programme, introductive lessons about theory and practice of teaching and feedback, including the ‘Briefing, Intraoperative Teaching, Debriefing Model for Teaching in the Operating Room’ (BID model), were integrated into an established Masterclass for Bariatric Surgery. The lectures and discussions lasted about 90 minutes and were guided by two medical educators. The theoretical part was directly followed by a hands-on teaching and feedback session, where two gastric bypass operations were performed by two surgical trainees and two supervising surgeons, who all had attended the theoretical lesson. The intended goal was that they would directly apply the acquired knowledge, including the BID model, to a busy high-intensity situation. The other participants were to watch the operations, as is usually done in the setting of a masterclass, but this time were also asked to pay attention to the teaching and feedback process with the BID model in order to combine theory and practice. An evaluation was carried out immediately after the masterclass. What lessons were learned? Overall, 9/15 respondents strongly agreed and 6/15 agreed that the goal of gaining new insights into feedback theory and practice was achieved. However, only one participant agreed strongly and 8/15 agreed that the goal of integrating teaching and feedback methods during the live operations was achieved, and 6/15 participants rated this as neutral. Overall, theoretical inputs and new insights on teaching and feedback seemed to be welcomed by the audience. The practical implementation in the setting of a masterclass, however, was more difficult than expected. The reasons for these results seemed to be two-fold. First, we designed a multiple-teaching situation where the trainee was being taught during a challenging technical operation by a supervisor who himself was assessed for the implementation of the BID model. Second, most of the participants of the masterclass primarily participated by showing their interest in and asking questions about the challenges of the operational techniques, rather than the feedback process, because this was the habitual focus of their attention. Overall, introducing a theoretical background about teaching and feedback into a high-stakes surgical masterclass should be carefully balanced. The transfer of teaching techniques with the implementation of new tools in a multiple-teaching situation, even with an engaged team of medical educators, is aiming high. Clinical scenarios to introduce structured feedback should be less complex (e.g. low-stakes training sessions to start with) in order to shift the attention from the procedure itself to the training of teaching and feedback. Moreover, the feedback training should not only put the supervisor and the trainee into the active role of using the feedback tool, but should involve all participants equally.