Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK.
Surg Endosc. 2021 Jul;35(7):3787-3795. doi: 10.1007/s00464-020-07871-3. Epub 2020 Aug 17.
Laparoscopic skill acquisition involves a steep learning curve and laparoscopic suturing is an exceptionally challenging task. By improving the way feedback is given, trainees can learn these skills more effectively. This study aims to establish the most effective form of structured feedback on laparoscopic suturing skill acquisition in novices, by comparing the effects of expert verbal feedback, video review with expert feedback (video feedback), and video review with self-assessment.
A prospective randomized blinded trial comparing verbal feedback, video feedback, and self-assessment. Novices in laparoscopic surgery were tasked with performing laparoscopic suturing with intracorporeal knot tying. Time was given for practice, and pre- and post-feedback assessments were undertaken. Suturing performance was measured using a task-specific checklist and global ratings. A post-study questionnaire was used to measure participant-perceived confidence, knowledge, and experience levels.
Fifty-one participants were randomized and allocated equally into the three groups. Performance in all three groups improved significantly from baseline. Video feedback had the largest improvement margin with checklist and global score improvements of 17.1% (± 9.9%) and 14.7% (± 9.3%), respectively. Performance improvements between groups were statistically significant in the global components (p = 0.004) but not the checklist components (p = 0.186). Global score improvement was significantly better in the video feedback group but was statistically insignificant between the self-assessment and verbal feedback groups. Questionnaire responses demonstrated positive results in confidence, knowledge, and experience levels, across all three study groups, with no differences between the groups (p > 0.05).
Structured video feedback facilitates reflection and self-directed learning, which improves the ability to develop proficiency in surgical skills. Combining both self-assessment and video feedback may be beneficial over verbal feedback alone due to the advantages of video review. These techniques should therefore be considered for implementation into surgical education curricula.
腹腔镜技能的获得涉及陡峭的学习曲线，腹腔镜缝合是一项极具挑战性的任务。通过改进反馈方式，受训者可以更有效地学习这些技能。本研究旨在通过比较专家口头反馈、带专家反馈的视频回顾（视频反馈）和带自我评估的视频回顾，确定新手腹腔镜缝合技能获得中最有效的结构化反馈形式。
这是一项比较口头反馈、视频反馈和自我评估的前瞻性随机对照盲法试验。腹腔镜手术新手需要进行腹腔镜内打结的缝合。给予练习时间，并进行反馈前和反馈后的评估。使用特定任务检查表和总体评分来衡量缝合表现。研究后问卷调查用于衡量参与者感知的信心、知识和经验水平。
51 名参与者随机分组，每组各 17 人。所有三组的表现均从基线显著提高。视频反馈在检查表和总体评分方面的改善幅度最大，分别为 17.1%（±9.9%）和 14.7%（±9.3%）。组间在总体评分方面的表现改善具有统计学意义（p=0.004），但在检查表评分方面无统计学意义（p=0.186）。视频反馈组的总体评分改善明显更好，但与自我评估和口头反馈组之间无统计学差异。问卷调查结果表明，所有三组在信心、知识和经验水平方面均有积极结果，且组间无差异（p＞0.05）。
结构化视频反馈促进反思和自我指导学习，从而提高在手术技能方面达到熟练程度的能力。将自我评估与视频反馈相结合可能比单独使用口头反馈更有益，因为视频审查具有优势。因此，这些技术应考虑纳入手术教育课程。
