Purpose <p>To assess a program for resident surgical coaching.</p> Study design <p>A surgical coach observed surgical residents performing operations. The SIMPL questionnaire (1. How much guidance did you provide for the majority of the critical portion of this procedure? [best score 4, worst score 1]. What was this resident’s performance for the majority of the critical portion of this procedure? [best score 5, worst score 1]. How complex was this case relative to similar procedures? [hardest 1/3 3, easiest ½ 1]); and the Ottawa Competency Operating Room Scale (O-score) (1. Preprocedure plan, 2. Case preparation, 3. Knowledge of specific procedure steps, 4. Technical performance, 5. Visuospatial skills, 6. Postprocedure plan, 7. Efficiency and flow, and 8. Communication were completed). The coach would discuss specific observations of the resident’s performance. A survey was completed by residents and faculty assessing the program’s value.</p> Results <p>54 surgical residents with 28 faculty completed 137 sessions. The median number of sessions for an individual resident was 2.5 (range 1–6). Both the SIMPL and O-score results were higher by resident year. Resident survey results: 100% felt sessions were valuable, with an open exchange, skills and ergonomics were most improved, and the most common suggestion for improvement was coaching more often. Faculty survey results: 93% coach was not a distraction, 69% saw improvement in resident skills, 79% sought feedback on teaching, and 93% felt that the program should continue.</p> Conclusions <p>The instruments could distinguish among resident level. Participants felt coaching was valuable, should continue, and be done more often.</p>