Raymond Mallory, Studer Matthew, Al-Mulki Kareem
Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA.
Ann Otol Rhinol Laryngol. 2023 Apr;132(4):440-448. doi: 10.1177/00034894221098804. Epub 2022 Jun 5.
Video-based coaching might complement general surgery education, but little is known of its applicability for otologic microsurgical teaching. Our purpose was thus to evaluate the content and resident-perceived benefit of video-based coaching for mastoidectomy education.
In this mixed-methods pilot design, mastoidectomies were recorded from operative microscopes and reviewed during 30-minute video-based coaching sessions at 2 tertiary care centers. Eight residents and 3 attendings participated. Ten-point Likert-type questionnaires on the extent to which attendings taught 12 topics through 8 techniques were completed by residents after surgical and coaching sessions. Coaching sessions and structured interviews with residents were audio-recorded, transcribed and iteratively coded.
Seven audio-recordings were available for coaching sessions, during which a mean of 2.22 ± 0.5 topics per minute were discussed. Of the 12 teaching topics, technique was discussed most frequently (32%, 0.71 ± 0.2 topics/min), followed by anatomy (16%, 0.31 ± 0.16 topics/min). Of all 8 ratings between coaching and operative sessions, residents indicated a greater extent of discussion of anatomy (median difference, [95% confidence interval (CI)] of 3 [1-4]), progress (2.25 [95% CI, 0.5-4]), technique (3.5 [95% CI, 1.5-5.5]), pitfalls (2.5 [95% CI, 1-3.5]), and summarizing (3 [95% CI, 1-5]). In structured interviews, residents reported improved self-confidence and global perspective.
Video-based coaching is educationally dense and characterized by perceived richer teaching and promotion of a deeper surgical understanding. It requires no additional resources, can be completed in a short period of time and can be implemented programmatically for any otolaryngologic subspecialty utilizing video-recording capable equipment.
基于视频的辅导可能会辅助普通外科教育,但对于其在耳科显微外科教学中的适用性知之甚少。因此,我们的目的是评估基于视频的辅导在乳突切除术教学中的内容以及住院医师所感知到的益处。
在这个混合方法的试点设计中,从手术显微镜记录乳突切除术,并在2个三级医疗中心进行的30分钟基于视频的辅导课程中进行回顾。8名住院医师和3名主治医师参与。住院医师在手术和辅导课程后完成关于主治医师通过8种技术讲授12个主题的程度的10点李克特式问卷。对辅导课程和与住院医师的结构化访谈进行录音、转录并反复编码。
有7份辅导课程的录音可用,在此期间平均每分钟讨论2.22±0.5个主题。在12个教学主题中,技术讨论最为频繁(32%,0.71±0.2个主题/分钟),其次是解剖学(16%,0.31±0.16个主题/分钟)。在辅导课程和手术课程之间的所有8项评分中,住院医师表示解剖学的讨论程度更高(中位数差异,[95%置信区间(CI)]为3[1 - 4])、进展(2.25[95%CI,0.5 - 4])、技术(3.5[95%CI,1.5 - 5.5])、陷阱(2.5[95%CI,1 - 3.5])和总结(3[95%CI,1 - 5])。在结构化访谈中,住院医师报告自信心和整体视野有所提高。
基于视频的辅导教学内容丰富,其特点是教学丰富且有助于提升对手术的深入理解。它无需额外资源,可在短时间内完成,并且可以利用具备录像功能的设备以程序化方式应用于任何耳鼻喉科亚专业。