Colorectal Surgical Unit, University of Sheffield, Sheffield, UK; Academic Unit of Medical Education, University of Sheffield, Sheffield, UK.
Br J Surg. 2013 Oct;100(11):1448-53. doi: 10.1002/bjs.9237.
Constructive feedback provides a mechanism for reinforcing learning during the acquisition of surgical skills. Feedback is usually given verbally, and sometimes documented, after direct observation by a trained assessor. The aim was to evaluate video recording as an effective modality for enhancing feedback, in comparison with standard verbal feedback alone.
This was a prospective, blinded, randomized clinical trial comparing standard verbal feedback plus video with standard verbal feedback alone. Validated pro formas for assessment were used and quality control was performed by independent expert assessors. Trial participants were recorded on video performing the surgical skill, and returned the next day to perform the skill again following video and standard verbal feedback (group 1) or standard verbal feedback alone (group 2).
Forty-eight participants were divided equally between the two groups. There was a significant improvement in the mean overall procedure score for group 1 of 2·875 from a maximum achievable score of 20 (P = 0·003), but not for group 2. There were significant improvements in the specific domains of instrument familiarity, needle handling, skin handling and accurate apposition, again all in group 1. The only significant improvement in group 2 was in an organized approach to the task, also observed in group 1. Knot-tying security deteriorated after feedback in group 2 but not in group 1.
The addition of video feedback can improve the acquisition of surgical skills, and could be incorporated into formal surgical curricula.
建设性反馈为强化手术技能习得过程中的学习提供了一种机制。反馈通常是在经过训练的评估者直接观察后口头提供的，有时也会记录下来。目的是评估录像作为增强反馈的有效方式的效果，与仅提供标准口头反馈相比。
这是一项前瞻性、盲法、随机临床试验，比较了标准口头反馈加视频与仅标准口头反馈。使用了经过验证的评估表格，并由独立的专家评估者进行质量控制。试验参与者在录像中进行手术技能操作，然后第二天在观看录像和标准口头反馈后（第 1 组）或仅接受标准口头反馈（第 2 组）的情况下再次进行该操作。
48 名参与者被平均分为两组。第 1 组的总操作评分从 20 分的最高可得分数提高了 2.875 分（P=0.003），而第 2 组没有显著提高。在器械熟悉度、针处理、皮肤处理和准确对位等具体领域都有显著提高，这些都仅在第 1 组中观察到。第 2 组唯一显著提高的是任务的有条理方法，这也在第 1 组中观察到。第 2 组的打结安全性在反馈后恶化，但第 1 组没有。
添加视频反馈可以提高手术技能的习得，并且可以纳入正式的外科课程。
