Department of Surgery and Cancer, Imperial College, 10th Floor Queen Elizabeth Queen Mother Building, St Mary's Hospital, London, W2 1NY, UK.
Surg Endosc. 2024 Oct;38(10):5793-5802. doi: 10.1007/s00464-024-11174-2. Epub 2024 Aug 15.
Routine surgical video recording has multiple benefits. Video acts as an objective record of the operative record, allows video-based coaching and is integral to the development of digital technologies. Despite these benefits, adoption is not widespread. To date, only questionnaire studies have explored this failure in adoption. This study aims to determine the barriers and provide recommendations for the implementation of routine surgical video recording.
A pre- and post-pilot questionnaire surrounding a real-world implementation of a C-SATS, an educational recording and surgical analytics platform, was conducted in a university teaching hospital trust. Usage metrics from the pilot study and descriptive analyses of questionnaire responses were used with the non-adoption, abandonment, scale-up, spread, sustainability (NASSS) framework to create topic guides for semi-structured interviews. Transcripts of interviews were evaluated in an inductive thematic analysis.
Engagement with the C-SATS platform failed to reach consistent levels with only 57 videos uploaded. Three attending surgeons, four surgical residents, one scrub nurse, three patients, one lawyer, and one industry representative were interviewed, all of which perceived value in recording. Barriers of 'change,' 'resource,' and 'governance,' were identified as the main themes. Resistance was centred on patient misinterpretation of videos. Participants believed availability of infrastructure would facilitate adoption but integration into surgical workflow is required. Regulatory uncertainty was centred around anonymity and data ownership.
Barriers to the adoption of routine surgical video recording exist beyond technological barriers alone. Priorities for implementation include integration recording into the patient record, engaging all stakeholders to ensure buy-in, and formalising consent processes to establish patient trust.
常规手术视频记录有多种好处。视频作为手术记录的客观记录，允许基于视频的指导，并且是数字技术发展的组成部分。尽管有这些好处，但采用并不广泛。迄今为止，只有问卷调查研究探索了这种采用失败。本研究旨在确定障碍，并为常规手术视频记录的实施提供建议。
在一所大学教学医院信托中，围绕 C-SATS（一种教育记录和手术分析平台）的实际实施情况进行了一项预试点和试点后问卷调查。试点研究的使用指标和问卷调查答复的描述性分析使用非采用、放弃、扩展、传播、可持续性（NASSS）框架为半结构化访谈创建主题指南。对访谈的文字记录进行了归纳主题分析。
与 C-SATS 平台的互动未能达到一致水平，仅上传了 57 个视频。采访了三位主治外科医生、四位外科住院医师、一位手术室护士、三位患者、一位律师和一位行业代表，他们都认为录制有价值。“变革”、“资源”和“治理”障碍被确定为主要主题。阻力集中在患者对视频的误解上。参与者认为基础设施的可用性将促进采用，但需要将其整合到手术工作流程中。监管方面的不确定性集中在匿名性和数据所有权上。
常规手术视频记录的采用存在障碍，不仅仅是技术障碍。实施的优先事项包括将记录整合到患者记录中，让所有利益相关者参与以确保获得认可，并正式制定同意程序以建立患者信任。
