Kennedy Aidan, Lee Adrianna, Ambinder David, Naslund Michael, Siddiqui M Minhaj, Phelan Michael, Malik Rena D
Department of Urology, University of Maryland, Baltimore, Maryland.
Urol Pract. 2021 May;8(3):393-401. doi: 10.1097/UPJ.0000000000000211. Epub 2020 Nov 30.
Surgical experience requires skills traditionally taught through real-time operating room education and a variety of supplemental educational strategies. Video-based coaching is a modality that may offer potential advantages of immediate, direct and targeted feedback. The objective of this study was to demonstrate and evaluate the utility and educational value of video-based coaching in urology by conducting a qualitative analysis with a coding schema.
Residents and attendings were recorded operating during randomly selected cases in the operating room. Video-based coaching sessions were held during urology grand rounds and required residents to describe a selected portion of the operating room video and attendings to provide teaching points. Audio recordings from the operating room and video-based coaching sessions were reviewed by 2 independent coders. A coding scale classifying surgical educational goals into 5 categories (information, operative technique, questioning, response to resident interaction and unrelated commenting) was used to identify the interactions and was adjusted for time.
Four urological cases were selected for recording. In the video-based coaching sessions compared to the operating room, attendings made more teaching points per hour, provided more information to residents (mean teaching points 7.7 for video-based coaching vs 2.9 for operating room, p <0.005), emphasized operative skills and technique (mean teaching points 10.5 for video-based coaching vs 4.1 for operating room, p <0.005), and were more likely to ask open-ended discussion leading questions (mean teaching points 28.5 for video-based coaching vs 4.4 for operating room, p <0.05).
Video-based coaching delivered in short time frames offers an easily implementable additional learning opportunity for resident education to further enhance skills learned in the urological operating room.
外科手术经验需要通过实时手术室教育及各种补充教育策略来传授传统技能。基于视频的指导是一种可能具有即时、直接和针对性反馈等潜在优势的方式。本研究的目的是通过使用编码方案进行定性分析,来展示和评估基于视频的指导在泌尿外科中的实用性和教育价值。
在手术室随机选择的病例手术过程中对住院医师和主治医生进行录像。在泌尿外科大查房期间进行基于视频的指导课程,要求住院医师描述手术室视频的选定部分,主治医生提供教学要点。两名独立编码员对手术室和基于视频的指导课程的录音进行审查。使用一个将外科教育目标分为五类(信息、手术技术、提问、对住院医师互动的回应和无关评论)的编码量表来识别互动情况,并根据时间进行调整。
选择了四个泌尿外科病例进行记录。与手术室相比,在基于视频的指导课程中,主治医生每小时给出的教学要点更多,向住院医师提供的信息更多(基于视频的指导平均教学要点为7.7,手术室为2.9,p<0.005),强调手术技能和技术(基于视频的指导平均教学要点为10.5,手术室为4.1,p<0.005),并且更有可能提出开放式讨论引导性问题(基于视频的指导平均教学要点为28.5,手术室为4.4,p<0.05)。
在短时间内提供的基于视频的指导为住院医师教育提供了一个易于实施的额外学习机会,以进一步提高在泌尿外科手术室学到的技能。