Randomized Control Trial Evaluating Different Modalities of Real-Time Surgical Feedback.

INTRODUCTION

: Surgical training is a constant exchange between trainers and trainees, and intraoperative surgical feedback is an integral part of learning. New technologies in robotic surgery allow for the delivery of visual aid and verbal feedback intraoperatively, but it has not yet been determined if feedback type affects the trainee learning process.

METHODS

: 49 novice participants were recruited and randomized into four feedback groups: , , of verbal/visual, and no feedback (). Participants completed a suturing task three times (pre-test, feedback, post-test). Suturing videos were retrospectively graded utilizing a standard rubric, and performance scores were compared across feedback groups utilizing hierarchical modeling.

RESULTS

: Each group had similar pre-test performance (p>0.05). Comparison between pre-test and post-test performance revealed statistically significant improvements in performance across feedback groups for and , but did not improve (interaction test: p<0.001). and demonstrated significant improvement in as compared to (p=0.004 and p=0.002). During the feedback round, received statistically significantly less feedback as compared to and before consistently utilizing the correct technique for (p<0.001, p=0.013). also received statistically significantly less feedback as compared to for (p=0.006). Finally, participants in and required significantly less on the delivered feedback compared to those in (p=0.004, p=0.001).

CONCLUSION

: Real-time surgical feedback—regardless of type—allows for marked improvement in correct technique. Additionally, a combination of both visual and verbal feedback may help surgical trainees learn more efficiently than verbal or visual feedback alone.