O'Connell Lauren, McKevitt Kevin, Khan Waqar, Waldron Ronan, Khan Iqbal, Barry Kevin
Department of Surgery, Mayo University Hospital, Castlebar, Co. Mayo, Ireland.
Department of Surgery, Mayo University Hospital, Castlebar, Co. Mayo, Ireland.
Surgeon. 2021 Oct;19(5):e107-e111. doi: 10.1016/j.surge.2020.08.011. Epub 2020 Sep 19.
Tools for improving operative performance for surgical trainees are increasingly desirable, particularly in the context of EWTD and 'run-through' training programmes. In addition, positive direct trainer feedback to trainees can improve skill acquisition and motivation, whilst negative feedback may have the opposite effect. We aimed to examine the impact of targeted trainer feedback based on video analysis on trainee confidence and objective operative performance in laparoscopic cholecystectomy.
Selected procedures designated as training cases were recorded. These were assessed by the trainers using the Independence-Scaled Procedural Assessment Score for laparoscopic cholecystectomy. Targeted feedback based on video review of selected procedures was then delivered by the trainers to the trainees. Trainees completed a self-reported questionnaire based on their response to this feedback. Subsequent to the feedback intervention, further training procedures were recorded and assessed.
A total of 6 trainees and 4 trainers participated in the study. For the pre-intervention assessment 15 cases were recorded, with a further 13 for the post-intervention assessment (total n = 28). The overall scores for the procedures performed post video feedback were improved, with a trend towards statistical significance (p = 0.08). However, there was a statistically significant improvement in the scores for performance of the triangle of Calot dissection after the feedback intervention (p = 0.009). The response rate to the questionnaire was 100%, with all trainees agreeing that they felt more confident and competent after the feedback intervention.
Targeted feedback to trainees based on post-procedure video review improves trainee confidence and may also improve performance. ACGME Core Competencies; Patient Care and Procedural Skills; Practice Based Learning and Improvement.
提高外科实习医生手术操作水平的工具越来越受到青睐，尤其是在欧洲工作时间指令（EWTD）和“全程”培训项目的背景下。此外，培训师对实习生的积极直接反馈可以提高技能习得和积极性，而消极反馈可能会产生相反的效果。我们旨在研究基于视频分析的针对性培训师反馈对实习生在腹腔镜胆囊切除术中的信心和客观手术操作表现的影响。
记录选定为培训案例的手术过程。培训师使用腹腔镜胆囊切除术的独立量表程序评估分数对这些手术进行评估。然后，培训师根据对选定手术的视频回顾向实习生提供针对性反馈。实习生根据他们对该反馈的反应完成一份自我报告问卷。在反馈干预之后，记录并评估进一步的培训手术。
共有6名实习生和4名培训师参与了该研究。干预前评估记录了15个案例，干预后评估又记录了13个案例（总计n = 28）。视频反馈后所执行手术的总体分数有所提高，有统计学显著性趋势（p = 0.08）。然而，反馈干预后，Calot三角解剖操作的分数有统计学显著性提高（p = 0.009）。问卷的回复率为100%，所有实习生都表示在反馈干预后他们感到更有信心和能力。
基于术后视频回顾对实习生进行针对性反馈可提高实习生的信心，也可能提高手术操作表现。美国毕业后医学教育认证委员会核心能力；患者护理和操作技能；基于实践的学习与改进。
