Moore Maureen D, Abelson Jonathan S, O'Mahoney Paul, Bagautdinov Iskander, Yeo Heather, Watkins Anthony C
Department of Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York.
Department of Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York.
J Surg Educ. 2018 Mar-Apr;75(2):497-502. doi: 10.1016/j.jsurg.2017.07.024. Epub 2017 Aug 31.
As an adjunct to simulation-based teaching, laparoscopic video-based surgical coaching has been an effective tool to augment surgical education. However, the wide use of video review in open surgery has been limited primarily due to technological and logistical challenges. The aims of our study were to (1) evaluate perceptions of general surgery (GS) residents on video-assisted operative instruction and (2) conduct a pilot study using a head-mounted GoPro in conjunction with the operative performance rating system to assess feasibility of providing video review to enhance operative feedback during open procedures.
GS residents were anonymously surveyed to evaluate their perceptions of oral and written operative feedback and use of video-based operative resources. We then conducted a pilot study of 10 GS residents to assess the utility and feasibility of using a GoPro to record resident performance of an arteriovenous fistula creation with an attending surgeon. Categorical variables were analyzed using the chi-square test.
Academic, tertiary medical center.
GS residents and faculty.
A total of 59 GS residents were anonymously surveyed (response rate = 65.5%). A total of 40% (n = 24) of residents reported that structured evaluations rarely or never provided meaningful feedback. When feedback was received, 55% (n = 32) residents reported that it was only rarely or sometimes in regard to their operative skills. There was no significant difference in surveyed responses among junior postgraduate year (PGY 1-2), senior (PGY 3-4), or chief residents (PGY-5). A total of 80% (n = 8) of residents found the use of GoPro video review very or extremely useful for education; they also deemed video review more useful for operative feedback than written or communicative feedback. An overwhelming majority (90%, n = 9) felt that video review would lead to improved technical skills, wanted to review the video with the attending surgeon for further feedback, and desired expansion of this tool to include additional procedures.
Although there has been progress toward improving operative feedback, room for further improvement remains. The use of a head-mounted GoPro is a dynamic tool that provides high-quality video for operative review and has the potential to augment the training experience of GS residents. Future studies exploring a wide array of open procedures involving a greater number of trainees will be needed to further define the use of this resource.
作为基于模拟教学的辅助手段，腹腔镜视频手术指导已成为增强外科教育的有效工具。然而，由于技术和后勤方面的挑战，视频回顾在开放手术中的广泛应用受到了限制。我们研究的目的是：（1）评估普通外科（GS）住院医师对视频辅助手术指导的看法；（2）开展一项试点研究，使用头戴式GoPro相机结合手术表现评分系统，评估在开放手术过程中提供视频回顾以增强手术反馈的可行性。
对GS住院医师进行匿名调查，以评估他们对口头和书面手术反馈以及基于视频的手术资源使用情况的看法。然后，我们对10名GS住院医师进行了一项试点研究，评估使用GoPro相机记录住院医师在主刀医生指导下创建动静脉内瘘手术表现的实用性和可行性。分类变量采用卡方检验进行分析。
学术性三级医疗中心。
GS住院医师和教员。
共对59名GS住院医师进行了匿名调查（回复率 = 65.5%）。共有40%（n = 24）的住院医师报告称，结构化评估很少或从未提供有意义的反馈。当收到反馈时，55%（n = 32）的住院医师报告称，反馈很少或只是有时涉及他们的手术技能。初级研究生（PGY 1 - 2）、高级研究生（PGY 3 - 4）或住院总医师（PGY - 5）的调查回复之间没有显著差异。共有80%（n = 8）的住院医师认为使用GoPro视频回顾对教育非常有用或极其有用；他们还认为视频回顾对手术反馈比书面或交流反馈更有用。绝大多数（90%，n = 9）认为视频回顾会提高技术技能，希望与主刀医生一起回顾视频以获得进一步反馈，并希望扩展该工具以涵盖更多手术。
尽管在改善手术反馈方面已经取得了进展，但仍有进一步改进的空间。使用头戴式GoPro相机是一种动态工具，可为手术回顾提供高质量视频，并有可能增强GS住院医师的培训体验。未来需要开展更多研究，探索涉及更多受训人员的各种开放手术，以进一步明确该资源的使用方法。
