Shafa Golsa, Kiani Parmiss, Masino Caterina, Okrainec Allan, Pasternak Jesse D, Alseidi Adnan, Madani Amin
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Surgical Artificial Intelligence Research Academy, University Health Network, Toronto, ON, Canada.
Surg Endosc. 2023 Dec;37(12):9406-9413. doi: 10.1007/s00464-023-10374-6. Epub 2023 Sep 5.
Continuing Professional Development opportunities for lifelong learning are fundamental to the acquisition of surgical expertise. However, few opportunities exist for longitudinal and structured learning to support the educational needs of surgeons in practice. While peer-to-peer coaching has been proposed as a potential solution, there remains significant logistical constraints and a lack of evidence to support its effectiveness. The purpose of this study is to determine whether the use of remote videoconferencing for video-based coaching improves operative performance.
Early career surgeon mentees participated in a remote coaching intervention with a surgeon coach of their choice and using a virtual telestration platform (Zoom Video Communications, San Jose, CA). Feedback was articulated through annotating videos. The coach evaluated mentee performance using a modified Intraoperative Performance Assessment Tool (IPAT). Participants completed a 5-point Likert scale on the educational value of the coaching program.
Eight surgeons were enrolled in the study, six of whom completed a total of two coaching sessions (baseline, 6-month). Subspecialties included endocrine, hepatopancreatobiliary, and surgical oncology. Mean age of participants was 39 (SD 3.3), with mean 5 (SD 4.1) years in independent practice. Total IPAT scores increased significantly from the first session (mean 47.0, SD 1.9) to the second session (mean 51.8, SD 2.1), p = 0.03. Sub-category analysis showed a significant improvement in the Advanced Cognitive Skills domain with a mean of 33.2 (SD 2.5) versus a mean of 37.0 (SD 2.4), p < 0.01. There was no improvement in the psychomotor skills category. Participants agreed or strongly agreed that the coaching programs can improve surgical performance and decision-making (coaches 85%; mentees 100%).
Remote surgical coaching is feasible and has educational value using ubiquitous commercially available virtual platforms. Logistical issues with scheduling and finding cases aligned with learning objectives continue to challenge program adoption and widespread dissemination.
持续专业发展的终身学习机会是获得外科专业技能的基础。然而，支持外科医生在实际工作中教育需求的纵向和结构化学习机会很少。虽然同行辅导已被提议作为一种潜在的解决方案，但仍然存在重大的后勤限制，并且缺乏支持其有效性的证据。本研究的目的是确定使用远程视频会议进行基于视频的辅导是否能提高手术操作表现。
早期职业外科医生学员与他们选择的外科教练一起参与了一项远程辅导干预，并使用了一个虚拟远程标注平台（Zoom视频通讯公司，加利福尼亚州圣何塞）。通过标注视频来明确反馈。教练使用改良的术中表现评估工具（IPAT）对学员的表现进行评估。参与者就辅导计划的教育价值完成了一个5级李克特量表。
8名外科医生参与了该研究，其中6人总共完成了两次辅导课程（基线、6个月）。亚专业包括内分泌、肝胆胰和外科肿瘤学。参与者的平均年龄为39岁（标准差3.3），独立执业的平均年限为5年（标准差4.1）。IPAT总分从第一节课（平均47.0，标准差1.9）到第二节课（平均51.8，标准差2.1）显著增加，p = 0.03。子类别分析显示，高级认知技能领域有显著改善，平均分为33.2（标准差2.5），而之前平均分为37.0（标准差2.4），p < 0.01。心理运动技能类别没有改善。参与者同意或强烈同意辅导计划可以提高手术表现和决策能力（教练85%；学员100%）。
使用普遍可用的商业虚拟平台进行远程手术辅导是可行的，并且具有教育价值。与学习目标一致的病例安排和寻找方面的后勤问题继续对该计划的采用和广泛传播构成挑战。
