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Sreedharan JK, Gopalakrishnan GK, Jose AM, Albalawi IA, Alkhathami MG, Satheesan KN, Alnasser M, AlEnezi M, Alqahtani AS. Simulation-Based Teaching and Learning in Respiratory Care Education: A Narrative Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:473-486. [PMID: 38826695 PMCID: PMC11144405 DOI: 10.2147/amep.s464629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/23/2024] [Indexed: 06/04/2024]
Abstract
Simulation-based pedagogy has become an essential aspect of healthcare education. However, there is a significant gap in the literature regarding the application of simulation-based modalities in respiratory care education. This review aims to address this gap by providing insight into the theory and current uses of simulation, its effectiveness in respiratory care education, and strategies to enhance faculty development. The study utilizes a narrative synthesis approach to review relevant literature and provide a comprehensive understanding of the topic. The research involved comprehensive searches of electronic databases, including PubMed and Google Scholar, to identify relevant literature, encompassing original articles, reviews, and other pertinent content, focusing on simulation-based teaching and learning in respiratory care education published between 1990 and 2022. Findings suggest that simulation-based education is an effective tool for improving respiratory care education and can enhance the clinical skills of learners. The study concludes by discussing the future of simulation in respiratory care education and the potential benefits it may offer.
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Affiliation(s)
- Jithin K Sreedharan
- Department of Respiratory Therapy, College of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
| | | | - Ann Mary Jose
- Department of Respiratory Care, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Ibrahim Ahmad Albalawi
- Advanced Centre for Clinical Simulation, Assistant Vice Dean of Academic Affairs, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
| | - Mohammed Ghaithan Alkhathami
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
| | - Keerthi N Satheesan
- Department of Respiratory Care, Royal Medical Services College of Nursing and Health Sciences, Manama, Bahrain
| | - Musallam Alnasser
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
| | - Meshal AlEnezi
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
| | - Abdullah S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Dammam, Saudi Arabia
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Caputo V, Denoyelle F, Simon F. Educational endoscopic videos improve teaching of middle ear anatomy. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08658-1. [PMID: 38642088 DOI: 10.1007/s00405-024-08658-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/03/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Videos and images are becoming an educational tool in every domain. The objective was to assess the contribution of short educational endoscopic videos in learning the complex anatomy of the tympanic cavity. METHODS We conducted a prospective study amongst all the otolaryngology residents in 2021 in the greater Paris area (n = 74), from the first year to fifth year. We divided the residents into two groups who had the same 30-min anatomy class based on anatomical drawings. The second group had a 4-min endoscopic educational video at the end, whereas the first group did not. A video test of 10 surgical situations with each time 5 anatomic structures to identify was created. All the residents took the test just after the class, and 1 month later to assess long-term memory. The MERSQI score (design to assess the quality of educational studies) applied to our study was calculated. RESULTS The two groups were comparable in terms of training. The "video" group had significantly better results in the first test, mean score 24.40/50 (± 11.7) versus 16.74/50 (± 11.1) (p = 0.005) and also at 1 month, mean score 23.25/50 (± 12.3) versus 18.01/50 (± 11.3) (p = 0.035). The score in each group, and the difference between both groups, increased with resident seniority. The MERSQI score of our study was 14.5/18. CONCLUSION This study highlights the educational value of videos to help memorise complex 3D anatomy such as in the tympanic cavity.
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Kim JS, Jonas N, Rizvi TZ, Lin Z, Plewa D, Ricard C, Cheah YL, Simon CJ, Wright V. Validation of a multidisciplinary virtual reality (VR) robotic surgical curriculum. J Robot Surg 2023; 17:2495-2502. [PMID: 37526810 DOI: 10.1007/s11701-023-01679-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/16/2023] [Indexed: 08/02/2023]
Abstract
The objective is to identify whether trainees demonstrate improvement in a standardized knot-tying task as assessed by Global Evaluative Assessment of Robotic Skills (GEARS) score after completion of a virtual reality (VR) robotic curriculum. An IRB-exempt prospective study was conducted with surgical trainees from August 2021 to February 2023. Participants initially performed a baseline robotic suturing task in which they were instructed to tie interrupted square knots in 10 min. Participants then completed a virtual reality simulation curriculum involving 23 exercises until they achieved 90% proficiency on all tasks. Participants then repeated the suturing task. Pre- and post-curriculum suturing tasks were recorded, de-identified, and scored by expert graders using a GEARS score. Trainees from three academic centers were invited to participate. Medical students (MS1-MS3) and surgical residents from gynecology, urology, and general surgery were invited to participate. Twenty-five trainees completed the pre-curriculum suturing task, the VR curriculum, and the post-curriculum suturing task. Trainees demonstrated significant improvement in their post-test GEARS score by 2.43 points (p < 0.05) and were able to tie three additional knots within 10 min after completion of the curriculum (p < 0.05). Trainees also demonstrated a faster time to complete first knot (114 s improvement, p < 0.05) after completion of the curriculum. All participants agreed or strongly agreed that completion of the robotic curriculum helped them feel more comfortable using the robotic console, and improved their robotic surgical skills. Surgical trainees and medical students with limited prior robotic surgical experience demonstrated objective improvement after completion of a standardized VR curriculum.
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Affiliation(s)
- Jessica S Kim
- Department of Gynecology, Beth Israel Lahey Health, 41 Burlington Mall Road, Burlington, MA, 01803, USA
| | - Nicholas Jonas
- Division of Surgical Simulation, Beth Israel Lahey Health, Burlington, MA, USA
- Department of General Surgery, New York-Presbyterian Queens, Flushing, New York, USA
| | - Tasneem Zaihra Rizvi
- Beth Israel Lahey Health, Burlington, MA, USA
- Department of General Surgery, Beth Israel Lahey Health, Burlington, MA, USA
| | - Zhibang Lin
- Beth Israel Lahey Health, Burlington, MA, USA
| | - Deanna Plewa
- Division of Surgical Simulation, Beth Israel Lahey Health, Burlington, MA, USA
- Department of General Surgery, Beth Israel Lahey Health, Burlington, MA, USA
| | - Caroline Ricard
- Division of Surgical Simulation, Beth Israel Lahey Health, Burlington, MA, USA
- Department of General Surgery, Tufts Medical Center, Boston, MA, USA
| | - Yee Lee Cheah
- Division of Transplantation, Department of Surgery, Beth Israel Lahey Health, Burlington, MA, USA
- Division of Transplant and Hepatobiliary Disease, Department of Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Caroline J Simon
- Division of Transplantation, Department of Surgery, Beth Israel Lahey Health, Burlington, MA, USA
- Division of Transplant and Hepatobiliary Disease, Department of Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Valena Wright
- Department of Gynecology, Beth Israel Lahey Health, 41 Burlington Mall Road, Burlington, MA, 01803, USA.
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Guo J, Guo Q, Feng M, Liu S, Li W, Chen Y, Zou J. The use of 3D video in medical education: A scoping review. Int J Nurs Sci 2023; 10:414-421. [PMID: 37545776 PMCID: PMC10401357 DOI: 10.1016/j.ijnss.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/01/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives The use of 3D video in medical education has not been fully explored. This article aims to review the evidence on 3D video currently presented in the medical education literature, including its impact on curriculum activities, to reference future research in this field. Methods According to the guidelines of Arksey and O'Malley, the authors used a systematic search strategy (the last search was in December 2022) to search nine literature databases published in English, and only primary studies were included. Two authors independently screened all articles based on the eligibility criteria and performed a thematic analysis of the included literature. Results Of 1,302 articles identified, 23 were included for insights into how opportunities for 3D video in medical education are created, how they are experienced, and how they influence and manifest behavior demonstrated partial congruency. Three themes were identified: (a) advantages of using 3D video in medical education; (b) the effect of using 3D video in medical education on students' academic achievement and ability; and (c) students' experience of 3D video in medical education. Conclusions The application of 3D video in medical education has won the support of most students and educators. However, the effect of using 3D video in medical education is still controversial. Medical educators should combine the curriculum's characteristics, the students' learning situation, and the existing educational resources and choose to use them after careful consideration.
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Affiliation(s)
- Juan Guo
- Sichuan Vocational College of Health and Rehabilitation, Zigong, China
- West China Hospital, Sichuan University, Chengdu, China
| | - Qingmin Guo
- Southwest Petroleum University, Chengdu, China
| | - Mei Feng
- West China Hospital, Sichuan University, Chengdu, China
| | - Shanshan Liu
- West China Hospital, Sichuan University, Chengdu, China
| | - Wenping Li
- Sichuan Vocational College of Health and Rehabilitation, Zigong, China
| | - Yuzhen Chen
- West China Hospital, Sichuan University, Chengdu, China
| | - Jinmei Zou
- Sichuan Vocational College of Health and Rehabilitation, Zigong, China
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Kiyasseh D, Laca J, Haque TF, Miles BJ, Wagner C, Donoho DA, Anandkumar A, Hung AJ. A multi-institutional study using artificial intelligence to provide reliable and fair feedback to surgeons. COMMUNICATIONS MEDICINE 2023; 3:42. [PMID: 36997578 PMCID: PMC10063640 DOI: 10.1038/s43856-023-00263-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/17/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Surgeons who receive reliable feedback on their performance quickly master the skills necessary for surgery. Such performance-based feedback can be provided by a recently-developed artificial intelligence (AI) system that assesses a surgeon's skills based on a surgical video while simultaneously highlighting aspects of the video most pertinent to the assessment. However, it remains an open question whether these highlights, or explanations, are equally reliable for all surgeons. METHODS Here, we systematically quantify the reliability of AI-based explanations on surgical videos from three hospitals across two continents by comparing them to explanations generated by humans experts. To improve the reliability of AI-based explanations, we propose the strategy of training with explanations -TWIX -which uses human explanations as supervision to explicitly teach an AI system to highlight important video frames. RESULTS We show that while AI-based explanations often align with human explanations, they are not equally reliable for different sub-cohorts of surgeons (e.g., novices vs. experts), a phenomenon we refer to as an explanation bias. We also show that TWIX enhances the reliability of AI-based explanations, mitigates the explanation bias, and improves the performance of AI systems across hospitals. These findings extend to a training environment where medical students can be provided with feedback today. CONCLUSIONS Our study informs the impending implementation of AI-augmented surgical training and surgeon credentialing programs, and contributes to the safe and fair democratization of surgery.
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Affiliation(s)
- Dani Kiyasseh
- Department of Computing and Mathematical Sciences, California Institute of Technology, Pasadena, CA, USA.
| | - Jasper Laca
- Center for Robotic Simulation and Education, Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Taseen F Haque
- Center for Robotic Simulation and Education, Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Brian J Miles
- Department of Urology, Houston Methodist Hospital, Houston, TX, USA
| | - Christian Wagner
- Department of Urology, Pediatric Urology and Uro-Oncology, Prostate Center Northwest, St. Antonius-Hospital, Gronau, Germany
| | - Daniel A Donoho
- Division of Neurosurgery, Center for Neuroscience, Children's National Hospital, Washington DC, USA
| | - Animashree Anandkumar
- Department of Computing and Mathematical Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Andrew J Hung
- Center for Robotic Simulation and Education, Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
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Belmar F, Gaete MI, Durán V, Chelebifski S, Jarry C, Ortiz C, Escalona G, Villagrán I, Alseidi A, Zamorano E, Pimentel F, Crovari F, Varas J. Taking advantage of asynchronous digital feedback: development of an at-home basic suture skills training program for undergraduate medical students that facilitates skills retention. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2023; 2:32. [PMID: 38013870 PMCID: PMC9900196 DOI: 10.1007/s44186-023-00112-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/27/2022] [Accepted: 01/28/2023] [Indexed: 02/08/2023]
Abstract
Purpose To date, there are no training programs for basic suturing that allow remote deliberate practice. This study seeks to evaluate the effectiveness of a basic suture skills training program and its 6-month skill retention applying unsupervised practice and remote digital feedback. Methods Fourth-year medical-student trainees reviewed instructional videos from a digital platform and performed unsupervised practice as needed at their homes. When they felt competent, trainees uploaded a video of themselves practicing the skill. In < 72 h, they received expert asynchronous digital feedback. The course had two theoretical stages and five video-based assessments, where trainees performed different suturing exercises. For the assessment, a global (GRS) and specific rating scale (SRS) were used, with a passing score of 20 points (max:25) and 15 (max:20), respectively. Results were compared to previously published work with in-person expert feedback (EF) and video-guided learning without feedback (VGL). A subgroup of trainees underwent a 6-month skills retention assessment. Results Two-hundred and forty-three trainees underwent the course between March and December 2021. A median GRS of 24 points was achieved in the final assessment, showing significantly higher scores (p < 0.001) than EF and VGL (20.5 and 15.5, respectively). Thirty-seven trainees underwent a 6-month skills retention assessment, improving in GRS (23.38 vs 24.03, p value = 0.06) and SRS (18.59 vs 19, p value = 0.07). Conclusion It is feasible to teach basic suture skills to undergraduate medical students using an unsupervised training course with remote and asynchronous feedback through a digital platform. This methodology allows continuous training with the repetition of quality practice, personalized feedback, and skills retention at 6 months.
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Affiliation(s)
- Francisca Belmar
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - María Inés Gaete
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - Valentina Durán
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - Slavka Chelebifski
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - Cristián Jarry
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - Catalina Ortiz
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - Gabriel Escalona
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - Ignacio Villagrán
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - Adnan Alseidi
- Department of Surgery, University of California San Francisco, San Francisco, CA USA
| | - Elga Zamorano
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
| | - Fernando Pimentel
- Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Fernando Crovari
- Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Julián Varas
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Marcoleta 377, 2nd floor, 8330024 Santiago, Chile
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Warehime JM, Lenger SM, Feng XY, Cope Z, Feroz R, Gaskins J, Gupta A, Francis S, Hamm J. Video Playback as an Educational Tool for Improving Resident Laparoscopic Performance: A Randomized Controlled Trial. J Minim Invasive Gynecol 2023; 30:39-44. [PMID: 36223862 DOI: 10.1016/j.jmig.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 01/05/2023]
Abstract
STUDY OBJECTIVE In this single-masked randomized controlled study, we evaluate whether watching video recordings of oneself performing Fundamentals of Laparoscopic Skills (FLS) exercises results in an improvement on the 30-point Global Operative Assessment of Laparoscopic Skills (GOALS) assessment among Obstetrics and Gynecology (Ob/Gyn) residents. DESIGN Twenty-three Ob/Gyn residents in the 2020-2021 academic year completed the FLS exercises while being timed, video recorded, and receiving real-time feedback from an Ob/Gyn faculty member. Baseline GOALS assessment was completed by participants and faculty. After the intervention, all participants then repeated the FLS exercises while being timed and were again scored using the GOALS assessment. Each participant completed the study in a single session. In addition, all participants completed a pre- and post-test survey. SETTING University of Louisville Laparoscopic Skills Labortaory. PARTICIPANTS University of Louisville Ob/Gyn residents in the 2020-2021 academic year. INTERVENTION Twelve participants were randomized to the intervention and were allowed to watch their video recording in addition to receiving verbal feedback whereas the remaining 11 received verbal feedback only. MEASUREMENTS AND MAIN RESULTS There were significant improvements in faculty (p <.01) and self-reported GOALS scores (p <.01) when comparing both the intervention and control group with baseline scores. The intervention group improved by 3.2 points more than that of the control group based on masked faculty evaluation (95% confidence interval, 1.4-5.0 points; p <.01). The difference was not significant in resident self-scores. Overall time improved for all participants (15:54 ± 0.21 minutes before and 13:13 ± 0.14 minutes after), but this difference was not significant between the 2 groups. Higher postgraduate year (PGY) residents reported significantly more comfort performing laparoscopic tasks, earned higher GOALS score (faculty and self-scores), and completed the first set of exercises in less time. A significant interaction between PGY and intervention was detected with improvement in GOALS score most strongly associated with PGY4 residents (p <.01). CONCLUSION Although all learners objectively benefit from watching recordings of themselves performing surgical tasks, advanced learners may benefit the most when video recordings are used as an educational tool.
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Affiliation(s)
- Jenna M Warehime
- From the Division of Female Pelvic Medicine and Reconstructive Surgery (Drs. Warehime, Lenger, Cope, Feroz, Gupta, and Francis), University of Louisville, Louisville, Kentucky.
| | - Stacy M Lenger
- From the Division of Female Pelvic Medicine and Reconstructive Surgery (Drs. Warehime, Lenger, Cope, Feroz, Gupta, and Francis), University of Louisville, Louisville, Kentucky
| | - Xiang Yu Feng
- Department of Obstetrics and Gynecology and Women's Health (Drs. Feng and Hamm), University of Louisville, Louisville, Kentucky
| | - Zebulun Cope
- From the Division of Female Pelvic Medicine and Reconstructive Surgery (Drs. Warehime, Lenger, Cope, Feroz, Gupta, and Francis), University of Louisville, Louisville, Kentucky
| | - Rehan Feroz
- From the Division of Female Pelvic Medicine and Reconstructive Surgery (Drs. Warehime, Lenger, Cope, Feroz, Gupta, and Francis), University of Louisville, Louisville, Kentucky
| | - Jeremy Gaskins
- and Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences (Dr. Gaskins), University of Louisville, Louisville, Kentucky
| | - Ankita Gupta
- From the Division of Female Pelvic Medicine and Reconstructive Surgery (Drs. Warehime, Lenger, Cope, Feroz, Gupta, and Francis), University of Louisville, Louisville, Kentucky
| | - Sean Francis
- From the Division of Female Pelvic Medicine and Reconstructive Surgery (Drs. Warehime, Lenger, Cope, Feroz, Gupta, and Francis), University of Louisville, Louisville, Kentucky
| | - Jennifer Hamm
- Department of Obstetrics and Gynecology and Women's Health (Drs. Feng and Hamm), University of Louisville, Louisville, Kentucky
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Kerr CL, Abdulghani M, Smith C, Khosa DK. Randomized Trial Comparing Instructor-Delivered Feedback with Self-Assessment Using Video during Basic Skills Training. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:790-798. [PMID: 34807806 DOI: 10.3138/jvme-2021-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Feedback has been shown to be one of the most powerful and effective influences on student achievement; however, the optimal method for providing feedback to trainees during veterinary skills training has yet to be determined. A prospective mixed-methods study was undertaken to evaluate student perceptions and performance outcomes with self-assessment using video- or instructor-delivered feedback during skills training using a model. Forty participants naïve to intravenous (IV) catheter placement were randomly assigned either to self-assessment using video or to instructor-directed feedback. A questionnaire probing participants' perceptions of their knowledge level and confidence in their skills was completed before and after the training, and an interview was done at study completion. Final skill performance was recorded using video capture to permit blind evaluations using a standard assessment tool. A quantitative evaluation of the performance and questionnaire scores, as well as a qualitative assessment of the interviews, was performed. Questionnaire scores were significantly higher in the post-study questionnaire for 12 of the 14 questions in both groups. Students assigned to the instructor-directed group had significantly higher scores than students in the self-directed group on the skill performance (p < .05). Self-reported confidence in knowledge and skill related to the IV catheterization technique improved with both self-directed feedback using video and instructor-directed feedback. Skill performance, however, was superior following instructor-directed feedback. Participants expressed positive experiences associated with use of the models for skills training, the value of the learning materials including the video, and guidance during learning.
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Morin L, Couineau F, Begon E, Walter A, Faucon B, Al Tabaa K. Randomized trial of the effect of video training on residents' surgical skills in facial skin reconstructive surgery: A SQUIRE study. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:321-325. [PMID: 35717531 DOI: 10.1016/j.anorl.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the impact of facial skin reconstruction training videos for head and neck and maxillofacial surgery residents. MATERIAL AND METHODS This randomized trial, conducted in France, involved residents in head and neck and maxillofacial surgery. A website was created containing facial skin reconstruction training videos. Selected residents performed facial skin flap dissections in the Paris School of Surgery. They were randomized into two groups, one receiving a standard course before the dissection, and the other a standard course plus a video of the flap ("no-video" and "video" groups). Each resident performed 4 facial flaps and was graded (blindly) during dissection. The main study endpoint was intergroup difference in grading score (out of 15). The article was written up following the SQUIRE-EDU (Standards for QUality Improvement Reporting Excellence in EDUcation) criteria. RESULTS Eighteen residents were included. For the main endpoint, scores were significantly higher in the "video" than the "no-video" group (6 [IQR, 4: 9] vs. 10 [9: 12]; P<0.001). In addition, as secondary endpoint, "no-video" group residents requested more assistance (3 [2: 4] vs. 1 [1: 2] P<0.001). Power was lacking for any subgroup analysis according to year of residency or to the 4 flaps. CONCLUSION Videos improved surgical residents' performance during dissections. However, these results would be difficult to transpose to real clinical conditions. They need validating in a larger study evaluating performance in real-life procedures.
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Affiliation(s)
- L Morin
- Service d'ORL, Hôpital René Dubos, Pontoise, France.
| | - F Couineau
- Service d'ORL, Hôpital Foch, Suresnes, France
| | - E Begon
- Service de Dermatologie, Hôpital René Dubos, Pontoise, France
| | - A Walter
- Service de Dermatologie, Hôpital René Dubos, Pontoise, France
| | - B Faucon
- Service d'ORL, Hôpital René Dubos, Pontoise, France
| | - K Al Tabaa
- Service d'ORL, Hôpital René Dubos, Pontoise, France
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Kanters AE, Evilsizer SK, Regenbogen SE, Hendren S, Campbell DA, Dimick JB, Byrn JC. Correlation of Colorectal Surgical Skill With Patient Outcomes: A Cautionary Tale. Dis Colon Rectum 2022; 65:444-451. [PMID: 34840292 DOI: 10.1097/dcr.0000000000002124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Previous work has demonstrated a correlation between video ratings of surgical skill and clinical outcomes. Some have proposed the use of video review for technical skill assessment, credentialing, and quality improvement. OBJECTIVE Before its adoption as a quality measure for colorectal surgeons, we must first determine whether video-based skill assessments can predict patient outcomes among specialty surgeons. DESIGN Twenty-one surgeons submitted one representative video of a minimally invasive colectomy. Each video was edited to highlight key steps and then rated by 10 peer surgeons using a validated American Society of Colon and Rectal Surgeons assessment tool. Linking surgeons' ratings to a validated surgical outcomes registry, we assessed the relationship between skill and risk-adjusted complication rates. SETTINGS The study was conducted with the Michigan Surgical Quality Collaborative, a statewide collaborative including 70 community, academic, and tertiary hospitals. PATIENTS Patients included those who underwent minimally invasive colorectal resection performed by the participating surgeons. MAIN OUTCOME MEASURES Main outcome measures included 30-day risk-adjusted postoperative complications. RESULTS The average technical skill rating for each surgeon ranged from 2.6 to 4.6. Risk-adjusted complication rate per surgeon ranged from 9.9% to 33.1%. Patients of surgeons in the bottom quartile of overall skill ratings were older and more likely to have hypertension or to smoke; patients of surgeons in the top quartile were more likely to be immunosuppressed or have an ASA score of 3 or higher. After patient- and surgery-specific risk adjustment, there was no statistically significant difference in complication rates between the bottom and top quartile surgeons (17.5% vs 16.8%, respectively, p = 0.41). LIMITATIONS Limitations included retrospective cohort design with short-term follow-up of sampled cases. Videos were edited to highlight key steps, and reviewers did not undergo training to establish norms. CONCLUSIONS Our study demonstrates that video-based peer rating of minimally invasive colectomy was not correlated with postoperative complications among specialty surgeons. As such, the adoption of video review for use in credentialing should be approached with caution. See Video Abstract at http://links.lww.com/DCR/B802.CORRELACIÓN ENTRE LA HABILIDAD QUIRÚRGICA COLORRECTAL Y LOS RESULTADOS OBTENIDOS EN EL PACIENTE: RELATO PRECAUTORIOANTECEDENTES:Trabajos anteriores han demostrado una correlación entre la video-calificación de la habilidad quirúrgica y los resultados clínicos. Algunos autores han propuesto el uso de la revisión de videos para la evaluación de la habilidad técnica, la acreditación y la mejoría en la calidad quirúrgica.OBJETIVO:Antes de su adopción como medida de calidad entre los cirujanos colorrectales, primero debemos determinar si las evaluaciones de habilidades basadas en video pueden predecir los resultados clínicos de los pacientes entre cirujanos especializados.DISEÑO:Veintiún cirujanos enviaron un video representativo de una colectomía mínimamente invasiva. Cada video fue editado para resaltar los pasos clave y luego fué calificado por 10 cirujanos revisores utilizando una herramienta de evaluación validada por la ASCRS. Al vincular las calificaciones de los cirujanos al registro de resultados quirúrgicos aprobado, evaluamos la relación entre la habilidad y las tasas de complicaciones ajustadas al riesgo.AJUSTE:Colaboración en todo el estado incluyendo 70 hospitales comunitarios, académicos y terciarios, el Michigan Surgical Quality Collaborative.PACIENTES:Todos aquellos sometidos a resección colorrectal mínimamente invasiva realizada por los cirujanos participantes.MEDIDA DE RESULTADO PRINCIPAL:Complicaciones posoperatorias ajustadas al riesgo a los 30 días.RESULTADOS:La calificación de la habilidad técnica promedio de cada cirujano osciló entre 2.6 y 4.6. La tasa de complicaciones ajustada al riesgo por cirujano osciló entre el 9,9% y el 33,1%. Los pacientes operados por los cirujanos del cuartil inferior de las calificaciones generales de habilidades eran fumadores y añosos, y tambiés más propensos a la hipertensión arterial. Los pacientes operados por los cirujanos del cuartil superior tenían más probabilidades de ser inmunosuprimidos o tener una puntuación ASA> = 3. Después del ajuste de riesgo específico de la cirugía y el paciente, no hubo diferencias estadísticamente significativas en las tasas de complicaciones entre los cirujanos del cuartil inferior y superior (17,5% frente a 16,8%, respectivamente, p = 0,41).LIMITACIONES:Diseño de cohortes retrospectivo con seguimiento a corto plazo de los casos muestreados. Los videos se editaron para resaltar los pasos clave y los revisores no recibieron capacitación para establecer normas.CONCLUSIONES:Nuestro estudio demuestra que la evaluación realizada por los revisores basada en el video de la colectomía mínimamente invasiva no se correlacionó con las complicaciones post-operatorias entre los cirujanos especialistas. Por tanto, la adopción de la revisión del video quirúrgico para su uso en la acreditación profesional, debe abordarse con mucha precaución. Consulte Video Resumen en http://links.lww.com/DCR/B802. (Traducción-Dr. Xavier Delgadillo).
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Affiliation(s)
- Arielle E Kanters
- Department of Surgery, Michigan Medicine, Ann Arbor, Michigan
- Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
| | | | - Scott E Regenbogen
- Department of Surgery, Michigan Medicine, Ann Arbor, Michigan
- Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
| | - Samantha Hendren
- Department of Surgery, Michigan Medicine, Ann Arbor, Michigan
- Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
| | | | - Justin B Dimick
- Department of Surgery, Michigan Medicine, Ann Arbor, Michigan
- Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
| | - John C Byrn
- Department of Surgery, Michigan Medicine, Ann Arbor, Michigan
- Center for Health Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
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Hall JM, Pyper JS. Exploring the nature and focus of feedback when using video playback in gynecology laparoscopy training. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:62-71. [PMID: 35003432 PMCID: PMC8740259 DOI: 10.36834/cmej.71455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Feedback about intraoperative performance remains a cornerstone of surgical training. Video playback offers one potential method for more effective feedback to surgical residents. More research is needed to better understand this method. This study explores the nature of instructional interactions and feedback in the operating room (OR) and when using video playback during post-operative review in obstetrics and gynecology (OBGYN) training. METHOD This case study occurred between September 2016 and February 2017. Three OBGYN residents and five OBGYN supervising surgeons were involved in six laparoscopic cases. Intraoperative and video playback dialogues were recorded and analysed, the former deductively using codes identified from published literature, and the latter both deductively, using the same codes, and inductively, with codes that emerged from the data during analysis. RESULTS 1090 intraoperative interactions were identified within 376 minutes of dialogue. Most interactions were didactic, instructing the resident how to use an instrument to perform a task. Deductive analysis of postoperative video playback review identified 146 interactions within 155 minutes. While the most common interaction type remained didactic, a teaching component was included more often. It became apparent that deductive analysis using the intraoperative codes did not adequately capture the nature and focus of feedback during video playback. Hermeneutic phenomenological analysis identified more dialogic video playback sessions with more resident-initiated questions and reflection. CONCLUSIONS This study demonstrates that the nature of feedback during video playback is fundamentally different from that in the OR, offering a greater potential for collaborative and improved learning.
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Affiliation(s)
- Jena M Hall
- Department of Obstetrics and Gynecology, Queen’s University, Ontario, Canada
| | - Jamie S Pyper
- Faculty of Education, Queen’s University, Ontario, Canada
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Soares RR, Sieber MR, Talcott KE, Chiang A, Garg SJ. A Comparative Analysis of Use of Google Glass versus. GoPro Intraoperative Video Recording of Scleral Buckle Surgery. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2021. [DOI: 10.1055/s-0041-1733931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Importance The scleral buckle technique is difficult to teach, given a decrease in the frequency of its use and the challenges of its video recording.
Background This study compares two different modalities for recording intraoperative videos of scleral buckle surgery.
Design Present study is a cross-sectional survey conducted in an academic hospital.
Participants A total of 36 medical students, ophthalmologic residents, and vitreoretinal surgery fellows participated in this survey.
Methods Five scleral buckle surgeries were filmed simultaneously using Google Glass and GoPro. Single-masked survey of trainees comparing video and audio quality of 38 10-second clips from each device, and listing the steps of scleral buckle surgery. Institutional review board approval and informed consent were obtained.
Main Outcome Measures Trainees were asked for grading the video device with respect to audio and video quality as favorable or unfavorable.
Results GoPro clips had more favorable ratings of video (73.3%) and audio (75.9%), compared with Google Glass (36.7 and 58.5%, respectively; p < 0.005). A total of 2.8% respondents listed the correct order of surgical steps in pretest, compared with 55.6% in posttest (p < 0.005).
Conclusion and Relevance Wearable recording devices can allow for video recording of scleral buckle surgery which has high utility in teaching trainees. GoPro and Google Glass each have distinct advantages.
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Affiliation(s)
- Rebecca R. Soares
- The Retina Service of Wills Eye Hospital, MidAtlantic Retina, Philadelphia, Pennsylvania
| | - Melissa R. Sieber
- The Retina Service of Wills Eye Hospital, MidAtlantic Retina, Philadelphia, Pennsylvania
| | | | - Allen Chiang
- The Retina Service of Wills Eye Hospital, MidAtlantic Retina, Philadelphia, Pennsylvania
| | - Sunir J. Garg
- The Retina Service of Wills Eye Hospital, MidAtlantic Retina, Philadelphia, Pennsylvania
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Kaulfuss JC, Kluth LA, Marks P, Grange P, Fisch M, Chun FKH, Meyer CP. Long-Term Effects of Mental Training on Manual and Cognitive Skills in Surgical Education - A Prospective Study. JOURNAL OF SURGICAL EDUCATION 2021; 78:1216-1226. [PMID: 33257297 DOI: 10.1016/j.jsurg.2020.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/24/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Limited training opportunities and expanding requirements are challenging surgical education, calling for alternative training methods like simulation or mental training. The aim of this study is to evaluate short- and long-term effects of a structured mental training on surgical performance. DESIGN Medical students without laparoscopic experience were randomly assigned to 3 groups: (1) control (2) video training, and (3) video plus mental training performing 2 E-BLUS (European Training in Basic Laparoscopic Urological Skills) exercises, "peg transfer" (PT) and "cutting a circle" (CC). Group 3 performed a structured mental training course (identification of procedural key steps, relaxation, mental vocalization, and imaging). Longitudinal assessment including binominal checklists, global rating scales (GRS), procedural times, and Test of Performance Strategies (TOPS) were performed at baseline, day 2, 14, and after 16 months. Statistical analysis included ANOVA and general linear models with repeated measures. SETTING The study was conducted in "Olympus Training and Education Center Hamburg West" and "Endo Club Academy" at the University Medical Center Hamburg-Eppendorf. PARTICIPANTS Participants were eligible if they were medical students with no experience in laparoscopy. 24 participants were recruited and finished the study. RESULTS The mental training group maintained significantly better GRS scores at 16 months for PT (mean score 24.6 [95% CI: 21-28.25]) and CC (mean score 22.5 [18.4-26.6]) (both p < 0.01) and performed faster in the latter (261 seconds [Std. Dev 116] vs. 427 seconds [SD 132] vs. 368 seconds [SD 78]) compared to the other groups (p = 0.004). Longitudinally, mental training had a significant effect on TOPS scores and procedural times (p < 0.001 and p = 0.005, respectively). CONCLUSION In addition to short time efficacy, our study is the first to ascertain a positive long-term effect of mental training on manual and cognitive skills and might be a useful and cost-effective tool in surgical education.
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Affiliation(s)
- Julia C Kaulfuss
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Luis A Kluth
- Department of Urology, Goethe University Hospital Frankfurt, Frankfurt, Germany
| | - Phillip Marks
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Felix K H Chun
- Department of Urology, Goethe University Hospital Frankfurt, Frankfurt, Germany
| | - Christian P Meyer
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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McGann KC, Melnyk R, Saba P, Joseph J, Glocker RJ, Ghazi A. Implementation of an E-Learning Academic Elective for Hands-On Basic Surgical Skills to Supplement Medical School Surgical Education. JOURNAL OF SURGICAL EDUCATION 2021; 78:1164-1174. [PMID: 33309226 DOI: 10.1016/j.jsurg.2020.11.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/25/2020] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To examine the feasibility and utility of a completely online surgical skills elective for undergraduate medical students. DESIGN The fully asynchronous, one-week, online learning elective addressed surgical instrument identification, knot tying, and suturing. Tools for knowledge acquisition and self-practice were outlined and individualized performance feedback on technical skills performance was incorporated from peers and experts through video conference. SETTING University of Rochester School of Medicine & Dentistry, Rochester, NY. PARTICIPANTS A total of 86 third- and fourth-year medical students enrolled and successfully completed the elective. RESULTS At elective completion, nearly all students met their course objectives and significantly increased their confidence in surgical instrument identification, knot tying, and suturing. Objective measures of student knowledge and technical skills acquisition were overwhelmingly positive, and faculty and students were very satisfied with providing and receiving performance feedback. Students reported that expert feedback was more useful than peer feedback, and more students than faculty reported that the online modality was equivalent to an in-person session for performance review. CONCLUSIONS This innovative online surgical skills elective improved undergraduate medical student confidence, knowledge, and skillset with surgical instrument identification, knot tying, and suturing while also facilitating effective expert feedback on individual performance.
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Affiliation(s)
- Kevin C McGann
- University of Rochester School of Medicine & Dentistry, Rochester, New York
| | - Rachel Melnyk
- Department of Urology, Simulation Innovation Lab, University of Rochester Medical Center, Rochester, New York
| | - Patrick Saba
- Department of Urology, Simulation Innovation Lab, University of Rochester Medical Center, Rochester, New York
| | - Julian Joseph
- Department of Urology, Simulation Innovation Lab, University of Rochester Medical Center, Rochester, New York
| | - Roan J Glocker
- Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - Ahmed Ghazi
- Department of Urology, Simulation Innovation Lab, University of Rochester Medical Center, Rochester, New York.
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Video Feedback and Video Modeling in Teaching Laparoscopic Surgery: A Visionary Concept from Kiel. J Clin Med 2021; 10:jcm10010163. [PMID: 33466531 PMCID: PMC7796509 DOI: 10.3390/jcm10010163] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/28/2020] [Indexed: 12/17/2022] Open
Abstract
Learning curves for endoscopic surgery are long and flat. Various techniques and methods are now available for surgical endoscopic training, such as pelvitrainers, virtual trainers, and body donor surgery. Video modeling and video feedback are commonly used in professional training. We report, for the first time, the application of video modeling and video feedback for endoscopic training in gynecology. The purpose is to present an innovative method of training. Attendees (residents and specialists) of minimally invasive surgery courses were asked to perform specific tasks, which were video recorded in a multimodular concept. Feedback was given later by an expert at a joint meeting. The attendees were asked to fill a questionnaire in order to assess video feedback given by the expert. The advantages of video feedback and video modeling for the development of surgical skills were given a high rating (median 84%, interquartile ranges (IQR) 72.5–97.5%, n = 37). The question as to whether the attendees would recommend such training was also answered very positively (median 100%, IQR 89.5–100%, n = 37). We noted a clear difference between subjective perception and objective feedback (58%, IQR 40.5–76%, n = 37). Video feedback and video modeling are easy to implement in surgical training setups, and help trainees at all levels of education.
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Seifert LB, Herrera-Vizcaino C, Herguth P, Sterz J, Sader R. Comparison of different feedback modalities for the training of procedural skills in Oral and maxillofacial surgery: a blinded, randomized and controlled study. BMC MEDICAL EDUCATION 2020; 20:330. [PMID: 32972404 PMCID: PMC7513537 DOI: 10.1186/s12909-020-02222-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The feedback given to students plays an important role in their efficiency related to learning practical skills. In the present study, diverse feedback modalities have been investigated. Our hypothesis is that individualized and unsupervised video feedback can produce a similar learning experience as performing practical skills in an oral and maxillofacial surgery setting with conventional direct expert feedback (control group). METHODS This prospective, randomized, controlled, and blinded study compared direct expert feedback (DEF), individualized video feedback (IVF) and unsupervised video feedback (UVF). The participants were fourth-year dental students from University Goethe in Frankfurt. The students were assigned to one of the three feedback methods (n = 20 per group) using simple randomization. All participants watched an instruction video for an interdental ('Ernst') ligature and periphery venous catheterization. Next, the students were video recorded performing the tasks by themselves (pre-test). Following this, every student received feedback using one of the above-mentioned feedback modalities. The participants then performed the same task again while being video recorded (post-test) to measure the acquired competence. Six weeks later, the students participated in an objective structured clinical examination (OSCE) to evaluate their long-term knowledge retention. All examiners were blinded regarding the students' instructional approach and their affiliation in terms of the learning group. RESULTS For the interdental ligature, we found significant improvements in performance in each feedback modality group between the pre-test and post-test (p < 0.001). UVF had the strongest effect on performance time. The comparison between each group in the post-test showed no significant differences between the three groups. CONCLUSION This study showed that IVF and UVF can be considered an alternative or adjunct to conventional methods (i.e. DEF) when learning procedural skills in oral and maxillofacial surgery. However, DEF showed to be the most effective method of feedback and therefore preferable in teaching.
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Affiliation(s)
- Lukas B Seifert
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Carlos Herrera-Vizcaino
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Philipp Herguth
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Jasmina Sterz
- Department of Trauma, Reconstructive and Hand Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Robert Sader
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
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Halim J, Jelley J, Zhang N, Ornstein M, Patel B. The effect of verbal feedback, video feedback, and self-assessment on laparoscopic intracorporeal suturing skills in novices: a randomized trial. Surg Endosc 2020; 35:3787-3795. [PMID: 32804266 DOI: 10.1007/s00464-020-07871-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/05/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Laparoscopic skill acquisition involves a steep learning curve and laparoscopic suturing is an exceptionally challenging task. By improving the way feedback is given, trainees can learn these skills more effectively. This study aims to establish the most effective form of structured feedback on laparoscopic suturing skill acquisition in novices, by comparing the effects of expert verbal feedback, video review with expert feedback (video feedback), and video review with self-assessment. METHODS A prospective randomized blinded trial comparing verbal feedback, video feedback, and self-assessment. Novices in laparoscopic surgery were tasked with performing laparoscopic suturing with intracorporeal knot tying. Time was given for practice, and pre- and post-feedback assessments were undertaken. Suturing performance was measured using a task-specific checklist and global ratings. A post-study questionnaire was used to measure participant-perceived confidence, knowledge, and experience levels. RESULTS Fifty-one participants were randomized and allocated equally into the three groups. Performance in all three groups improved significantly from baseline. Video feedback had the largest improvement margin with checklist and global score improvements of 17.1% (± 9.9%) and 14.7% (± 9.3%), respectively. Performance improvements between groups were statistically significant in the global components (p = 0.004) but not the checklist components (p = 0.186). Global score improvement was significantly better in the video feedback group but was statistically insignificant between the self-assessment and verbal feedback groups. Questionnaire responses demonstrated positive results in confidence, knowledge, and experience levels, across all three study groups, with no differences between the groups (p > 0.05). CONCLUSION Structured video feedback facilitates reflection and self-directed learning, which improves the ability to develop proficiency in surgical skills. Combining both self-assessment and video feedback may be beneficial over verbal feedback alone due to the advantages of video review. These techniques should therefore be considered for implementation into surgical education curricula.
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Affiliation(s)
- Jonathan Halim
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK.
| | - Joshua Jelley
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Ningning Zhang
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Marcus Ornstein
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - Bijendra Patel
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
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Patel R, Green W, Shahzad MW, Church H, Sandars J. Using a self-regulated learning-enhanced video feedback educational intervention to improve junior doctor prescribing. MEDICAL TEACHER 2020; 42:886-895. [PMID: 32301633 DOI: 10.1080/0142159x.2020.1748183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Introduction: Medical school graduates in the UK consistently report feeling underprepared for the task of prescribing when embarking on practice. The effective application of self-regulated learning (SRL) approaches and feedback on complex tasks are associated with improved outcomes in practice-based clinical skills.Aims: This study aimed to investigate the effectiveness of an educational intervention using SRL-enhanced video feedback for improving the prescribing competency of junior doctors.Methods: A prospective cohort study was designed to compare intervention and control cohorts of junior doctors undertaking simulated clinical encounters at the beginning and end of their 4-month rotation through renal medicine.Results: The improvement in prescribing competency for the intervention cohort was significant (p < 0.001) with large effect size (d = 1.42). Self-efficacy improved in both cohorts with large (control cohort p = 0.026, r= 0.64) and medium (intervention cohort p = 0.083, d = 0.55) effect sizes. Goal setting and self-monitoring skills improved in the intervention cohort only with medium effect size (p = 0.096, d = 0.53).Conclusions: SRL-enhanced video feedback is effective for improving prescribing competency and developing SRL processes such as goal setting and self-monitoring skills in simulated clinical encounters. Further research is required to evaluate transferability to other clinical sub-speciality contexts and investigate the effectiveness of the intervention for improving prescribing in non-simulated settings.
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Affiliation(s)
- Rakesh Patel
- School of Medicine, University of Nottingham, Nottingham, UK
| | - William Green
- Innovation, Technology and Operations Division, University of Leicester School of Business, University of Leicester, Leicester, UK
| | - Muhammad Waseem Shahzad
- Innovation, Technology and Operations Division, University of Leicester School of Business, University of Leicester, Leicester, UK
| | - Helen Church
- School of Medicine, University of Nottingham, Nottingham, UK
| | - John Sandars
- Health Research Institute, Faculty of Health, Social Care and Medicine, Edge Hill University Medical School, Ormskirk, UK
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Green W, Shahzad MW, Wood S, Martinez Martinez M, Baines A, Navid A, Jay R, Whysall Z, Sandars J, Patel R. Improving junior doctor medicine prescribing and patient safety: An intervention using personalised, structured, video-enhanced feedback and deliberate practice. Br J Clin Pharmacol 2020; 86:2234-2246. [PMID: 32343422 PMCID: PMC7576627 DOI: 10.1111/bcp.14325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/11/2020] [Accepted: 03/26/2020] [Indexed: 11/28/2022] Open
Abstract
AIMS This research investigated the effectiveness of an intervention for improving the prescribing and patient safety behaviour among Foundation Year doctors. The intervention consisted of simulated clinical encounters with subsequent personalised, structured, video-enhanced feedback and deliberate practice, undertaken at the start of four-month sub-specialty rotations. METHODS Three prospective, non-randomised control intervention studies were conducted, within two secondary care NHS Trusts in England. The primary outcome measure, error rate per prescriber, was calculated using daily prescribing data. Prescribers were grouped to enable a comparison between experimental and control conditions using regression analysis. A break-even analysis evaluated cost-effectiveness. RESULTS There was no significant difference in error rates of novice prescribers who received the intervention when compared with those of experienced prescribers. Novice prescribers not participating in the intervention had significantly higher error rates (P = .026, 95% confidence interval [CI] Wald 0.093 to 1.436; P = .026, 95% CI 0.031 to 0.397) and patients seen by them experienced significantly higher prescribing error rates (P = .007, 95% CI 0.025 to 0.157). Conversely, patients seen by the novice prescribers who received the intervention experienced a significantly lower rate of significant errors compared to patients seen by the experienced prescribers (P = .04, 95% CI -0.068 to -0.001). The break-even analysis demonstrates cost-effectiveness for the intervention. CONCLUSION Simulated clinical encounters using personalised, structured, video-enhanced feedback and deliberate practice improves the prescribing and patient safety behaviour of Foundation Year doctors. The intervention is cost-effective with potential to reduce avoidable harm.
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Affiliation(s)
- William Green
- University of Leicester School of Business, University of Leicester, Leicester, UK
| | | | - Stephen Wood
- University of Leicester School of Business, University of Leicester, Leicester, UK
| | - Maria Martinez Martinez
- Leicester General Hospital, University Hospitals of Leicester (UHL) NHS Trust, Leicester, UK
| | - Andrew Baines
- Pilgrim Hospital Boston, United Lincolnshire Hospitals (ULH) NHS Trust, Boston, Lincolnshire, UK
| | - Ahmad Navid
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Robert Jay
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Zara Whysall
- Department of Human Resource Management, Nottingham Business School, Nottingham Trent University, Nottingham, UK
| | - John Sandars
- Health Research Institute, Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, Lancashire, UK
| | - Rakesh Patel
- School of Medicine, University of Nottingham, Nottingham, UK
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Coffman JM, McConkey MJ, Colee J. Effectiveness of video-assisted, self-directed, and peer-guided learning in the acquisition of surgical skills by veterinary students. Vet Surg 2020; 49:582-589. [PMID: 31916633 DOI: 10.1111/vsu.13368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 11/17/2019] [Accepted: 11/30/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine the influence of self-directed learning, peer feedback, or expert feedback on suturing technique of novice veterinary student surgeons. STUDY DESIGN Prospective, blinded, video feedback study. SAMPLE POPULATION Three groups of surgery naïve veterinary students, two groups of 37 students and one group with 36 students. METHODS Each student completed three cruciate sutures in SynDaver skin. Student performance was video recorded and scored with a validated pro forma. Students were randomly divided into three groups: (1) students critically evaluated their own performance, (2) students critically evaluated peer's performance, and (3) students received a peer's evaluation. Each student repeated the surgical task and assessed his or her own performance, guided by the pro forma. Each student received a video with individualized feedback from an expert prior to repeating the task. Scores and times were analyzed. Student and expert evaluations were compared. RESULTS Task composite score, time to completion, and completion rate did not differ between groups. Student self-assessed scores did not correlate with expert scores. Forty-three percent and 62% of students stated that self-feedback and peer feedback, respectively, were acceptable forms of learning, and 96% of students felt expert feedback was superior to both. CONCLUSION Video-based self-evaluation and peer-assisted learning were as effective as expert feedback after didactic lecture in teaching suturing technique to novice veterinary surgeons. CLINICAL SIGNIFICANCE Video-based self-evaluation and peer feedback were viable alternative teaching strategies to didactic lecture and expert feedback alone for instructing novice veterinary surgeons.
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Affiliation(s)
- Jonathan M Coffman
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Marina J McConkey
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - James Colee
- IFAS Statistical Consulting Unit, University of Florida, Gainesville, Florida
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21
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Matthan J, Gray M, Nesbitt CI, Bookless L, Stansby G, Phillips A. Perceived Anxiety is Negligible in Medical Students Receiving Video Feedback During Simulated Core Practical Skills Teaching: A Randomised Trial Comparing Two Feedback Modalities. Cureus 2020; 12:e7486. [PMID: 32351863 PMCID: PMC7188453 DOI: 10.7759/cureus.7486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction The ability to undertake simple practical procedures is essential for graduating medical students and is typically assessed using simulated models. Feedback is a key component of the learning process in developing proficiency in these key skills. Video feedback (VF) has previously shown promise, however, negative effects of VF-related anxiety on performance have been previously reported. Our aim was to investigate for a difference in participant anxiety between supervised individualised video feedback (SIVF) and unsupervised generic video feedback (UGVF) when undertaking simulated basic practical procedures. Methods Undergraduate medical students participating in a clinical skills study to compare UGVF and SIVF completed a Likert scale questionnaire detailing perceived anxiety. During the study, students were recorded performing three basic surgical skills (simple interrupted suturing, intravenous cannulation, urinary catheterisation). Feedback was then provided by one of two methods: (1) SIVF - participant video footage reviewed together with a tutor providing targeted feedback, and (2) UGVF - participant video footage reviewed alone with concurrent access to a generic pre-recorded ‘expert tips' video clip for comparison. Each participant received SIVF and UGVF at least once. Results The majority of participants did not find either SIVF (81.7%) or UGVF (78.8%) stressful. Students had a strong preference for SIVF (77.5%) and disagreed that similar ‘face-to-face’ feedback had impaired learning in the past (80.3%). Conclusion Medical student-perceived anxiety is negligible when video feedback is employed during simulated core practical skill training.
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Affiliation(s)
- Joanna Matthan
- Dental Sciences, Newcastle University, Faculty of Medical Sciences, Newcastle upon Tyne, GBR
| | - Matthew Gray
- Department of Trauma and Orthopaedics, Royal Victoria Infirmary, Newcastle upon Tyne, GBR
| | - Craig I Nesbitt
- Vascular Surgery, Freeman Hospital, Newcastle upon Tyne, GBR
| | - Lucy Bookless
- Surgery, Northumbria Healthcare Trust, Newcastle upon Tyne, GBR
| | - Gerard Stansby
- Vascular Surgery, Freeman Hospital, Newcastle upon Tyne, GBR
| | - Alexander Phillips
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, GBR
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22
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Group Video Feedback is an Effective and Efficient Tool for Enhancing Skills of Surgical Interns. J Surg Res 2020; 251:248-253. [PMID: 32179277 DOI: 10.1016/j.jss.2020.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/02/2020] [Accepted: 01/25/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Our group has shown that personalized video feedback (PVF) is better than a task demonstration video at increasing wound closure skills among incoming surgical interns. However, offering PVF can be time-consuming. We sought to compare the educational effects and time required for group video feedback (GVF) and PVF. METHODS We have mailed our matched incoming "surgical" interns a "welcome package" in mid-March for the past 3 y. The package includes similar resources each year. Incoming interns were asked to video record themselves performing six tasks three separate times between April 1 and June 15. After each submission in 2016 and 2017, incoming interns received 2 min of personalized feedback on their three separate wound closure videos (PVF). In 2018, incoming interns received 5 min of group-based feedback three separate times covering all six tasks (GVF). We compared performance (July Surgical Olympics) of these six skills against the interns from the previous 2 y who received PVF on only one skill (suturing). RESULTS Twenty-three incoming interns received the pre-residency package and participated in the 2018 Surgical Olympics. This 2018 GVF class had a higher overall mean score for six stations (31.5 [standard deviation = ±7.7]) than the 2016 and 2017 PVF classes (25.6 [standard deviation = ±8]; P < 0.0001). Knot tying ability and suturing skill were similar between the classes. The GVF group performed better on the remaining four skills . The total time of surgical staff and educators spent per class in 2018 (GVF class) was 30 min and includes six tasks compared with 276 min of effort in each of the 2016 and 2017 classes (PVF included one task). CONCLUSIONS GVF and PVF as a component of preemptive training had the same effect on improving suturing skills among the interns. GVF required less educator editing and voice over time. GVF is effective and efficient in enhancing incoming interns' performance in multiple skills.
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Yu J, Lo C, Madampage C, Bajwa J, O'Brien J, Olszynski P, Lucy M. Video Modeling and Video Feedback to Reduce Time to Perform Intravenous Cannulation in Medical Students: A Randomized-Controlled Mixed-Methods Study. Can J Anaesth 2020; 67:715-725. [PMID: 32052372 DOI: 10.1007/s12630-020-01570-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Combined video modeling (VM) and video feedback (VF) may be more beneficial than traditional feedback when teaching procedural skills. This study examined whether repeated VM and VF compared with VM alone reduced the time required for medical students to perform peripheral intravenous (IV) cannulation. METHODS Twenty-five novice medical students were randomly assigned to groups in a one-way blinded embedded mixed-methods study to perform IV cannulation. Participants received standardized instruction and performed IV cannulation on each other while being audio-video recorded. They were assigned to review a video of an expert performing IV cannulation (VM alone), or both the expert video and a video of their own most recent IV cannulation (VM+VF), before returning to perform another IV cannulation. This was repeated for a total of four IV cannulation encounters and three video reviews. A post-test interview was also conducted and analyzed qualitatively using thematic content analysis. RESULTS The median [interquartile range] time required to perform IV cannulation in the final encounter was significantly different between the VM+VF group vs VM alone group (126 [93-226] sec vs 345 [131-537] sec, respectively; median difference, 111 sec; 95% confidence interval, 8 to 391; P = 0.02). There was no significant difference in IV cannulation success between VM alone and VM+VF in the final encounter (75% vs 85% respectively; P = 0.65). For the VM+VF group, the time to perform IV cannulation was reduced after the final encounter compared with the baseline encounter (P = 0.002), which was not true of the VM alone group (P = 0.35). CONCLUSION Video modeling and feedback shortened time to IV skill completion, reduced complications, and improved satisfaction in novice medical students.
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Affiliation(s)
- Julie Yu
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.
| | - Calvin Lo
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Claudia Madampage
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Jagmeet Bajwa
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Jennifer O'Brien
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Paul Olszynski
- Department of Emergency Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada
| | - Malcolm Lucy
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
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Ho K, Yao C, Novak Lauscher H, Koehler BE, Shojania K, Jamal S, Collins D, Kherani R, Meneilly G, Eva K. Remote assessment via video evaluation (RAVVE): a pilot study to trial video-enabled peer feedback on clinical performance. BMC MEDICAL EDUCATION 2019; 19:466. [PMID: 31852496 PMCID: PMC6921528 DOI: 10.1186/s12909-019-1905-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Video review processes for evaluation and coaching are often incorporated into medical education as a means to accurately capture physician-patient interactions. Compared to direct observation they offer the advantage of overcoming many logistical challenges. However, the suitability and viability of using video-based peer consultations for professional development requires further investigation. This study aims to explore the acceptability and feasibility of video-based peer feedback to support professional development and quality improvement in patient care. METHODS Five rheumatologists each provided four videos of patient consultations. Peers evaluated the videos using five-point scales, providing annotations in the video recordings, and offering recommendations. The rheumatologists reviewed the videos of their own four patient interactions along with the feedback. They were asked to document if they would make practice changes based on the feedback. Focus groups were conducted and analysed to explore the effectiveness of video-based peer feedback in assisting physicians to improve clinical practice. RESULTS Participants felt the video-based feedback provided accurate and detailed information in a more convenient, less intrusive manner than direct observation. Observations made through video review enabled participants to evaluate more detailed information than a chart review alone. Participants believed that reviewing recorded consultations allowed them to reflect on their practice and gain insight into alternative communication methods. CONCLUSIONS Video-based peer feedback and self-review of clinical performance is an acceptable and pragmatic approach to support professional development and improve clinical care among peer clinicians. Further investigation into the effectiveness of this approach is needed.
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Affiliation(s)
- Kendall Ho
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, 818 West 10th Avenue (3rd Floor), Vancouver, BC V5Z 1M9 Canada
| | - Christopher Yao
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, 818 West 10th Avenue (3rd Floor), Vancouver, BC V5Z 1M9 Canada
| | - Helen Novak Lauscher
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, 818 West 10th Avenue (3rd Floor), Vancouver, BC V5Z 1M9 Canada
| | - Barry E. Koehler
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, 10th Floor – 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - Kamran Shojania
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, 10th Floor – 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - Shahin Jamal
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, 10th Floor – 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - David Collins
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, 10th Floor – 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - Raheem Kherani
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, 10th Floor – 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - Graydon Meneilly
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, 10th Floor – 2775 Laurel Street, Vancouver, BC V5Z 1M9 Canada
| | - Kevin Eva
- Centre for Health Education Scholarship, Department of Medicine, Faculty of Medicine, University of British Columbia, P.A. Woodward Instructional Resources Centre, 429 – 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
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Augestad KM, Butt K, Ignjatovic D, Keller DS, Kiran R. Video-based coaching in surgical education: a systematic review and meta-analysis. Surg Endosc 2019; 34:521-535. [PMID: 31748927 DOI: 10.1007/s00464-019-07265-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/12/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND In the era of competency-based surgical education, VBC has gained increased attention and may enhance the efficacy of surgical education. The objective of this systematic review was to summarize the existing evidence of video-based coaching (VBC) and compare VBC to traditional master-apprentice-based surgical education. METHODS We performed a systematic review and meta-analysis of randomized controlled trials (RCT) assessing VBC according to the PRISMA and Cochrane guidelines. The MEDLINE, EMBASE, and COCHRANE and Researchgate databases were searched for eligible manuscripts. Standard mean difference (SMD) of performance scoring scales was used to assess the effect of VBC versus traditional training without VBC (control). RESULTS Of 627 studies identified, 24 RCTs were eligible and evaluated. The studies included 778 surgical trainees (n = 386 VBC vs. n = 392 control). 13 performance scoring scales were used to assess technical competence; OSATS-GRS was the most common (n = 15). VBC was provided preoperative (n = 11), intraoperative (n = 1), postoperative (n = 10), and perioperative (n = 2). The majority of studies were unstructured, where identified coaching frameworks were PRACTICE (n = 1), GROW (n = 2) and Wisconsin Coaching Framework (n = 1). There was an effect on performance scoring scales in favor of VBC coaching (SMD 0.87, p < 0.001). In subgroup analyses, the residents had a larger relative effect (SMD 1.13; 0.61-1.65, p < 0.001) of VBC compared to medical students (SMD 0.43, 0.06-0.81, p < 0.001). The greatest source of potential bias was absence of blinding of the participants and personnel (n = 20). CONCLUSION Video-based coaching increases technical performance of medical students and surgical residents. There exist significant study and intervention heterogeneity that warrants further exploration, showing the need to structure and standardize video-based coaching tools.
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Affiliation(s)
- Knut Magne Augestad
- Department of Postgraduate Surgical Education, University Hospital North Norway, Tromsö, Norway. .,Department of GI Surgery, Sandnessjøen Regional Hospital, Sandnessjøen, Norway. .,Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA.
| | - Khayam Butt
- Department of GI Surgery, Nordlandssykehuset, Bodø, Norway
| | - Dejan Ignjatovic
- Department of GI Surgery, Akershus University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Deborah S Keller
- Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA
| | - Ravi Kiran
- Division of Colorectal Surgery, Columbia University Medical Center, New York, NY, USA
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Theodore S, Grant HM, Budrow JJ, Fernandez GL, Tashjian DB, Seymour NE. Boot Camp in a Box: Initial Experience with Pretraining Skills Preparation for New Interns. JOURNAL OF SURGICAL EDUCATION 2019; 76:e225-e231. [PMID: 31471156 DOI: 10.1016/j.jsurg.2019.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/17/2019] [Accepted: 07/27/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE In order to increase selected skills at onset of training, we provided newly matched PGY-1 trainees with materials and instructions to practice these skills, as well as the opportunity to share video-recorded performance and receive feedback based on these videos. METHODS Knot tying and suturing kits, instruments and supplies, and video instructions for task performance were sent to newly matched trainees to our program (n = 10), with instructions to practice 4 tasks (1- and 2-handed knot tying, interrupted and running suturing) until self-assessed comfort with each task was achieved or the 8-week time point before start of training was reached. Each trainee returned a video of each task, which was graded by blinded reviewers for time and errors using an itemized evaluation instrument (12 items for suturing and five items for knot-tying). Feedback (annotations of submitted videos) was provided after grading was completed. Task performance was repeated and reassessed at the time of new intern "Boot Camp" and again 8 weeks after start of training. Performance scores were compared for the 3 time points and with scores of PGY 2-4 residents using ANOVA with posthoc tests. RESULTS Compliance with instruction for practice and return of video recorded tasks in the months before start of PGY-1 training was high, with only 1 of 10 failing to return knot-tying videos. A significant pattern of performance change (p < 0.05) was observed for all tasks with an initial decrease between the pre-employment practice period and the Boot Camp test followed by an increase to the highest level of performance 2 months after start of training. At that point, scores were not significantly different than those of more senior residents. CONCLUSIONS A high level of compliance was achieved with requested skills practice and video documentation of performance. We attribute the consistently lower scores on the tasks during Boot Camp tests to higher stress test environment which was apt to be less favorable than having the trainee choose to submit their best possible preresidency video recording of performance in a low-stress situation. Subsequent achievement of significantly higher performance even compared to more senior residents may have been helped by incentivized pretraining practice.
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Affiliation(s)
- Sheina Theodore
- Department of Surgery Baystate Health, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts
| | - Heather M Grant
- Department of Surgery Baystate Health, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts
| | - John J Budrow
- Department of Surgery Baystate Health, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts
| | - Gladys L Fernandez
- Department of Surgery Baystate Health, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts
| | - David B Tashjian
- Department of Surgery Baystate Health, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts
| | - Neal E Seymour
- Department of Surgery Baystate Health, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts.
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Farooq A, Reso A, Harvey A. Instant replay: Evaluation of instant video feedback in surgical novices for a laparoscopic gallbladder dissection. Am J Surg 2019; 215:943-947. [PMID: 29395018 DOI: 10.1016/j.amjsurg.2018.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/06/2018] [Accepted: 01/12/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Athletes often use video to improve their technique. We hypothesized that surgical novices given feedback using video-replay would outperform surgical novices given verbal feedback in the performance of a laparoscopic task. METHODS Our study used a prospective, randomized control design. The surgical task involved the laparoscopic dissection of a pig gallbladder. Our participants performed a dissection, pre- and post-traditional or video feedback. Each recording was independently scored by two staff surgeons using the previously validated rating tools. RESULTS There was no significant difference between video feedback or traditional feedback groups in their mean overall or task specific scores. Both traditional and video-feedback groups had a trend towards improved performance post-feedback. CONCLUSIONS No significant difference in performance by both our global assessment metrics or task-specific metrics was observed. Video feedback requires further study to investigate its impact on surgical training.
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Affiliation(s)
- Ameer Farooq
- Section of General Surgery, Department of Surgery, University of Calgary, Room 1023, North Tower, 1403 - 29 St, T2N 2T9, Calgary, AB, Canada
| | - Artan Reso
- Section of General Surgery, Department of Surgery, University of Calgary, Room 1023, North Tower, 1403 - 29 St, T2N 2T9, Calgary, AB, Canada.
| | - Adrian Harvey
- Section of General Surgery, Department of Surgery, Room 1005, North Tower, 1403 - 29 St, T2N 2T9, Calgary, AB, Canada.
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Buchanan IA, Min E, Pham MH, Donoho DA, Bakhsheshian J, Minneti M, Zada G, Giannotta SL, Hsieh PC, Liu JC. Simulation of Dural Repair in Minimally Invasive Spine Surgery With the Use of a Perfusion-Based Cadaveric Model. Oper Neurosurg (Hagerstown) 2019; 17:616-621. [DOI: 10.1093/ons/opz041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 02/14/2019] [Indexed: 01/22/2023] Open
Abstract
Abstract
BACKGROUND AND IMPORTANCE
In an era of curtailed work hours and concerns over achieving technical proficiency in the repertoire of procedures necessary for independent practice, many residencies have turned to model simulation as an educational adjunct. Cerebrospinal fluid (CSF) leak repair after inadvertent durotomy in spine surgery is a fundamental skillset for any spine surgeon. While primary closure with suture is not always necessary for small durotomies, larger defects, on the other hand, must be repaired. However, the dire consequences of inadequate repair dictate that it is generally performed by the most experienced surgeon. Few intraoperative opportunities, therefore, exist for CSF leak repair by trainees.
OBJECTIVE
To simulate dural repair in spine surgery using minimal-access techniques.
METHODS
A cohort of 8 neurosurgery residents was evaluated on their durotomy repair efforts in a perfusion-based cadaveric model.
RESULTS
Study participants demonstrated consistent improvement across trials, with a significant reduction in closure times between their initial (12 min, 7 sec ± 4 min, 43 sec) and final attempts (7 min, 4 sec ± 2 min, 6 sec; P = .02). Moreover, all trainees—irrespective of postgraduate year—were able to accomplish robust dural closures resistant to simulated Valsalva maneuvers. Participants reported high degrees of model realism and exhibited significant increases in postprocedure confidence scores.
CONCLUSION
Our results support use of perfusion-based simulation models as a complement to neurosurgery training, as it affords unrestricted opportunities for honing psychomotor skillsets when resident learning is increasingly being challenged by work-hour limitations and stricter oversight in the context of value-based healthcare.
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Affiliation(s)
- Ian A Buchanan
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Elliot Min
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Martin H Pham
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Daniel A Donoho
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Joshua Bakhsheshian
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Michael Minneti
- Department of General Surgery, University of Southern California, Los Angeles, California
| | - Gabriel Zada
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Steven L Giannotta
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Patrick C Hsieh
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - John C Liu
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
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Rammell J, Matthan J, Gray M, Bookless LR, Nesbitt CI, Rodham P, Moss J, Stansby G, Phillips AW. Asynchronous Unsupervised Video-Enhanced Feedback As Effective As Direct Expert Feedback in the Long-Term Retention of Practical Clinical Skills: Randomised Trial Comparing 2 Feedback Methods in a Cohort of Novice Medical Students. JOURNAL OF SURGICAL EDUCATION 2018; 75:1463-1470. [PMID: 29748142 DOI: 10.1016/j.jsurg.2018.03.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/23/2018] [Accepted: 03/26/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To determine the degree of practical clinical skills' retention over a 7-week period after receiving either video-enhanced direct expert feedback (DEF) or asynchronous unsupervised video-enhanced feedback (UVF). DESIGN A prospective single-blinded randomized trial was conducted over a 7-week period with novice medical students. Following a generic introduction, PowerPoint presentation and live demonstration of intravenous cannulation was given by an expert, and candidates performed the same task in isolation while being recorded and were randomized to receive either DEF or UVF. Further, 20 students were randomized to receive UVF and 22 to receive DEF. Candidates returned to repeat the video-recorded task at week 1, 4, and 7, with no further feedback provision on these occasions. Performances were fully anonymized and independently marked by 2 expert assessors. SETTING Newcastle University, Medical School, England, United Kingdom. PARTICIPANTS A total of 42 novice medical students from the preclinical years were selected, with no prior experience of intravenous cannulation. RESULTS No significant difference existed between demographics of either cohort. Good between-assessor score correlation was noted, with an intraclass correlation coefficient (ICC) of 0.89. The DEF arm significantly improved from their prefeedback performance at Day 1 on repeating the skill a week later (p < 0.0001); this improved score was maintained throughout the duration of the study. The UVF arm showed a nonsignificant improvement; however, there was no significant difference in the scores between the UVF and the DEF groups at any point in the trial. CONCLUSIONS Video-technology may play a significant role in the provision of feedback for practical skills. The ability for experts to provide remotely delivered but individualized feedback can be an efficient use of valuable resources, while students being able to self-assess their own performance alongside an expert video have the potential to provide students with an excellent opportunity to learn clinical skills without requiring intensive educator involvement.
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Affiliation(s)
- James Rammell
- North Tees and Hartlepool NHS Foundation Trust, Stockton, United Kingdom.
| | - Joanna Matthan
- Faculty of Medical Sciences, School of Medical Education, Newcastle University, Newcastle, United Kingdom
| | - Matthew Gray
- County Durham and Darlington NHS Foundation Trust, Durham, United Kingdom
| | - Lucy R Bookless
- County Durham and Darlington NHS Foundation Trust, Durham, United Kingdom
| | - Craig I Nesbitt
- Newcastle Upon Tyne Hospitals NHS foundation Trust, Newcastle, United Kingdom
| | - Paul Rodham
- Newcastle Upon Tyne Hospitals NHS foundation Trust, Newcastle, United Kingdom
| | - John Moss
- Faculty of Medical Sciences, School of Medical Education, Newcastle University, Newcastle, United Kingdom
| | - Gerard Stansby
- Newcastle Upon Tyne Hospitals NHS foundation Trust, Newcastle, United Kingdom
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Ahmet A, Gamze K, Rustem M, Sezen KA. Is Video-Based Education an Effective Method in Surgical Education? A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2018; 75:1150-1158. [PMID: 29449162 DOI: 10.1016/j.jsurg.2018.01.014] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/21/2017] [Accepted: 01/16/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Visual signs draw more attention during the learning process. Video is one of the most effective tool including a lot of visual cues. This systematic review set out to explore the influence of video in surgical education. We reviewed the current evidence for the video-based surgical education methods, discuss the advantages and disadvantages on the teaching of technical and nontechnical surgical skills. METHODS This systematic review was conducted according to the guidelines defined in the preferred reporting items for systematic reviews and meta-analyses statement. The electronic databases: the Cochrane Library, Medline (PubMED), and ProQuest were searched from their inception to the 30 January 2016. The Medical Subject Headings (MeSH) terms and keywords used were "video," "education," and "surgery." We analyzed all full-texts, randomised and nonrandomised clinical trials and observational studies including video-based education methods about any surgery. "Education" means a medical resident's or student's training and teaching process; not patients' education. We did not impose restrictions about language or publication date. RESULTS A total of nine articles which met inclusion criteria were included. These trials enrolled 507 participants and the total number of participants per trial ranged from 10 to 172. Nearly all of the studies reviewed report significant knowledge gain from video-based education techniques. The findings of this systematic review provide fair to good quality studies to demonstrate significant gains in knowledge compared with traditional teaching. Additional video to simulator exercise or 3D animations has beneficial effects on training time, learning duration, acquisition of surgical skills, and trainee's satisfaction. CONCLUSION Video-based education has potential for use in surgical education as trainees face significant barriers in their practice. This method is effective according to the recent literature. Video should be used in addition to standard techniques in the surgical education.
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Affiliation(s)
- Akgul Ahmet
- Department of Gerontology, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey.
| | - Kus Gamze
- Division of Physiotherapy and Rehabilitation, Institute of Health Science, Istanbul University, Istanbul, Turkey; Department of Physiotherapy and Rehabilitation, Mustafa Kemal University, Hatay, Turkey
| | - Mustafaoglu Rustem
- Department of Neurological Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Karaborklu Argut Sezen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey.
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Naik ND, Abbott EF, Gas BL, Murphy BL, Farley DR, Cook DA. Personalized video feedback improves suturing skills of incoming general surgery trainees. Surgery 2018; 163:921-926. [DOI: 10.1016/j.surg.2017.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022]
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Mookherjee S, Strujik J, Cunningham M, Kaplan E, Çoruh BA. Independent and mentored video review of OSCEs. CLINICAL TEACHER 2018; 16:23-29. [PMID: 29314581 DOI: 10.1111/tct.12755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Video review of OSCE (objective structured clinical examination) performance allows students to analyse their performance, identify actions and behaviours for correction or reinforcement, and develop a plan for improvement of clinical skills. Student perceptions of the utility of independent and mentored video review are unknown. METHODS We created a pilot programme of post-OSCE structured video review. Students were randomised to mentored (M) or independent (I) review. In the mentored group, a faculty member facilitated the process. Both groups completed an assessment rubric and created an action plan. We examined student perceptions of the process, helpful elements of each type of review and perceived impact after a follow-up OSCE. RESULTS The mentored group (n = 12) was more comfortable watching themselves than the independent group (n = 11); using a five-point Likert scale, where 1 indicates 'strongly disagree' and 5 indicates 'strongly agree': 3.5 ± 1.2 (I) versus 4.5 ± 0.2 (M) (p = 0.02). The mentored group more strongly agreed that their clinical skills would improve: 3.6 ± 1.1 (I) versus 4.9 ± 0.2 (M) (p < 0.01). After the follow-up OSCE, the mentored group (n = 10) tended to feel more strongly that their clinical skills had improved compared with the independent group (n = 9): 3.6 ± 1.3 (I) versus 4.3 ± 0.7 (M) (p = 0.14). DISCUSSION This pilot study demonstrates the utility of using a structured framework for post-OSCE video review, both for the assessment of performance and for the development of a behavioural action plan. There are advantages to using a mentor-guided model, but further study is needed to determine whether actual OSCE performances improve as a consequence. Video review of OSCE performance allows students to analyse their performance.
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Affiliation(s)
- Somnath Mookherjee
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jennie Strujik
- Department of Health Sciences Academic Services, University of Washington, Seattle, Washington, USA
| | - Matthew Cunningham
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Elizabeth Kaplan
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Bas Ak Çoruh
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington, USA
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Abbott EF, Thompson W, Pandian TK, Zendejas B, Farley DR, Cook DA. Personalized Video Feedback and Repeated Task Practice Improve Laparoscopic Knot-Tying Skills: Two Controlled Trials. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:S26-S32. [PMID: 29065020 DOI: 10.1097/acm.0000000000001924] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Compare the effect of personalized feedback (PF) vs. task demonstration (TD), both delivered via video, on laparoscopic knot-tying skills and perceived workload; and evaluate the effect of repeated practice. METHOD General surgery interns and research fellows completed four repetitions of a simulated laparoscopic knot-tying task at one-month intervals. Midway between repetitions, participants received via e-mail either a TD video (demonstration by an expert) or a PF video (video of their own performance with voiceover from a blinded senior surgeon). Each participant received at least one video per format, with sequence randomly assigned. Outcomes included performance scores and NASA Task Load Index (NASA-TLX) scores. To evaluate the effectiveness of repeated practice, scores from these trainees on a separate delayed retention test were compared against historical controls who did not have scheduled repetitions. RESULTS Twenty-one trainees completed the randomized study. Mean change in performance scores was significantly greater for those receiving PF (difference = 23.1 of 150 [95% confidence interval (CI): 0, 46.2], P = .05). Perceived workload was also significantly reduced (difference = -3.0 of 20 [95% CI: -5.8, -0.3], P = .04). Compared with historical controls (N = 93), the 21 with scheduled repeated practice had higher scores on the laparoscopic knot-tying assessment two weeks after the final repetition (difference = 1.5 of 10 [95% CI: 0.2, 2.8], P = .02). CONCLUSIONS Personalized video feedback improves trainees' procedural performance and perceived workload compared with a task demonstration video. Brief monthly practice sessions support skill acquisition and retention.
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Affiliation(s)
- Eduardo F Abbott
- E.F. Abbott is a simulation fellow, Mayo Clinic Multidisciplinary Simulation Center, Mayo Clinic College of Medicine, Rochester, Minnesota, and adjunct instructor of internal medicine, Department of Internal Medicine, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; ORCID: http://orcid.org/0000-0001-5713-4809. W. Thompson is a medical student, University of Minnesota Medical School, Minneapolis, Minnesota. T.K. Pandian is a resident, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota. B. Zendejas is a pediatric surgery fellow, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. D.R. Farley is professor of surgery and consultant, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota. D.A. Cook is professor of medicine and professor of medical education; research chair, Mayo Clinic Multidisciplinary Simulation Center; director of research, Office of Applied Scholarship and Education Science; and Consultant in the Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota; ORCID: http://orcid.org/0000-0003-2383-4633
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Hunukumbure AD, Smith SF, Das S. Holistic feedback approach with video and peer discussion under teacher supervision. BMC MEDICAL EDUCATION 2017; 17:179. [PMID: 28962567 PMCID: PMC5622503 DOI: 10.1186/s12909-017-1017-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 09/19/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND High quality feedback is vital to learning in medical education but many students and teachers have expressed dissatisfaction on current feedback practices. Lack of teachers' insight into students' feedback requirements may be a key, which might be addressed by giving control to the students with student led feedback practices. The conceptual framework was built on three dimensions of learning theory by Illeris and Vygotsky's zone of proximal development and scaffolding. We introduced a feedback session with self-reflection and peer feedback in the form of open discussion on video-recorded student performances under teacher's guidance. The aims of this qualitative study were to explore students' perception on this holistic feedback approach and to investigate ways of maximising effective feedback and learning. METHODS Semi-structured interviews were used to gather data which were evaluated using a thematic analytical approach. The participants were third year medical students of Imperial College London on clinical placements at Hillingdon Hospital. RESULTS Video based self-reflection helped some students to identify mistakes in communication and technical skills of which they were unaware prior to the session. Those who were new to video feedback found their expected self-image different to that of their actual image on video, leading to some distress. However many also identified that mistakes were not unique to themselves through peer videos and learnt from both model performances and from each other's mistakes. Balancing honest feedback with empathy was a challenge for many during peer discussion. The teacher played a vital role in making the session a success by providing guidance and a supportive environment. CONCLUSIONS This study has demonstrated many potential benefits of this holistic feedback approach with video based self-reflection and peer discussion with students engaging at a deeper cognitive level than the standard descriptive feedback.
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Affiliation(s)
| | - Susan F Smith
- Medical Education Research Unit, Alexander Fleming Building, Imperial College London, South Kensington Campus, London, SW7 2AZ UK
| | - Saroj Das
- Hillingdon Hospital, Pield Heath Road, Uxbridge, UB8 3NN UK
- Imperial College London, London, UK
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Nishizawa H, Kimura T. Enhancement of motor skill learning by a combination of ideal model-observation and self-observation. J Phys Ther Sci 2017; 29:1555-1560. [PMID: 28931987 PMCID: PMC5599820 DOI: 10.1589/jpts.29.1555] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 06/05/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] In sports physical therapy, video of a patient’s movement or of a skilled
model’s movement has been used as observational learning methods for injury prevention and
movement modification. Positive effects of model video observation have been reported.
This study aimed to clarify the effect on motor skill learning using a combination of
model-observation and self-observation, which is thought to act as an enhanced method for
active error detection by comparing model-observation and self-observation alone for
acquisition of correct sports movement. [Subjects and Methods] Forty-five healthy females
were randomly allocated into three groups comprising model- and self-observation,
model-observation, and self-observation. The motor task performed was a half golf swing
using an elastic club. Shoulder grip angle between both shoulder lines and the acromia
grip strength were measured as an index of body rotation using a three-dimensional motion
analyzer. Change in the shoulder grip angle in the three groups was analyzed at pre-,
immediate delayed retention, and delayed retention tests. [Results] A significant
difference in shoulder grip angle was observed among the three groups for the immediate
delayed retention test. The combined model and self-observation group had a value closer
to 90 degrees compared to the other two groups. [Conclusion] Observation combining model
and self-observation exerted a positive effect on short-term motor skill learning.
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Affiliation(s)
- Hitomi Nishizawa
- School of Health Sciences, Faculty of Medicine, Shinshu University: 3-1-1 Nagano, Asahi, Matsumoto 390-8621, Japan
| | - Teiji Kimura
- School of Health Sciences, Faculty of Medicine, Shinshu University: 3-1-1 Nagano, Asahi, Matsumoto 390-8621, Japan
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García-Granero E, Navarro F, Cerdán Santacruz C, Frasson M, García-Granero A, Marinello F, Flor-Lorente B, Espí A. Individual surgeon is an independent risk factor for leak after double-stapled colorectal anastomosis: An institutional analysis of 800 patients. Surgery 2017; 162:1006-1016. [PMID: 28739093 DOI: 10.1016/j.surg.2017.05.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/14/2017] [Accepted: 05/26/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Our aim was to assess whether the individual surgeon is an independent risk factor for anastomotic leak in double-stapled colorectal anastomosis after left colon and rectal cancer resection. METHODS This retrospective analysis of a prospectively collected database consists of a consecutive series of 800 patients who underwent an elective left colon and rectal resection with a colorectal, double-stapled anastomosis between 1993 and 2009 in a specialized colorectal unit of a tertiary hospital with 7 participating surgeons. The main outcome variable was anastomotic leak, defined as leak of luminal contents from a colorectal anastomosis between 2 hollow viscera diagnosed radiologically, clinically, endoscopically, or intraoperatively. Pelvic abscesses were also considered to be an anastomotic leak. Radiologic examination was performed when there was clinical suspicion of leak. RESULTS Anastomotic leak occurred in 6.1% of patients, of which 33 (67%) were treated operatively, 6 (12%) with radiologic drains, and 10 (21%) by medical treatment. Postoperative mortality rate was 2.9% for the whole group of 800 patients. In patients with anastomotic leak, mortality rate increased up to 16% vs 2.0% in patients without anastomotic leak (P < .0001). At multivariate analysis, rectal location of tumor, male sex, bowel obstruction preoperatively, tobacco use, diabetes, perioperative transfusion, and the individual surgeon were independent risk factors for anastomotic leak. The surgeon was the most important factor (mean odds ratio 4.9; range 1.0 to 13.5). The variance of anastomotic leak between the different surgeons was 0.56 in the logit scale. CONCLUSION The individual surgeon is an independent risk factor for leakage in double-stapled, colorectal, end-to-end anastomosis after oncologic left-sided colorectal resection.
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Affiliation(s)
- Eduardo García-Granero
- Department of General Surgery, Digestive Surgery Unit. Hospital Universitario y Politécnico la Fe, University of Valencia, Valencia, Spain
| | - Francisco Navarro
- Department of General Surgery, Colorectal Surgery Unit. Hospital de Manises, Manises, Valencia, Spain
| | - Carlos Cerdán Santacruz
- Department of General Surgery, Digestive Surgery Unit. Hospital Universitario y Politécnico la Fe, University of Valencia, Valencia, Spain.
| | - Matteo Frasson
- Department of General Surgery, Digestive Surgery Unit. Hospital Universitario y Politécnico la Fe, University of Valencia, Valencia, Spain
| | - Alvaro García-Granero
- Department of General Surgery, Digestive Surgery Unit. Hospital Universitario y Politécnico la Fe, University of Valencia, Valencia, Spain
| | - Franco Marinello
- Department of General Surgery, Colorectal Surgery Unit, Hospital Vall D´Hebrón, Barcelona, Spain
| | - Blas Flor-Lorente
- Department of General Surgery, Digestive Surgery Unit. Hospital Universitario y Politécnico la Fe, University of Valencia, Valencia, Spain
| | - Alejandro Espí
- Department of General Surgery, Hospital Clínico Universitario, Valencia, Spain
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Phillips AW, Matthan J, Bookless LR, Whitehead IJ, Madhavan A, Rodham P, Porter ALR, Nesbitt CI, Stansby G. Individualised Expert Feedback is Not Essential for Improving Basic Clinical Skills Performance in Novice Learners: A Randomized Trial. JOURNAL OF SURGICAL EDUCATION 2017; 74:612-620. [PMID: 28041770 DOI: 10.1016/j.jsurg.2016.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 11/07/2016] [Accepted: 12/07/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To determine whether unsupervised video feedback (UVF) is as effective as direct expert feedback (DEF) in improving clinical skills performance for medical students learning basic surgical skills-intravenous cannulation, catheterization, and suturing. BACKGROUND Feedback is a vital component of the learning process, yet great variation persists in its quality, quantity, and methods of delivery. The use of video technology to assist in the provision of feedback has been adopted increasingly. METHODS A prospective, blinded randomized trial comparing DEF, an expert reviewing students' performances with subsequent improvement suggestions, and UVF, students reviewing their own performance with an expert teaching video, was carried out. Medical students received an initial teaching lecture on intravenous cannulation, catheterization, and suturing and were then recorded performing the task. They subsequently received either DEF or UVF before reperforming the task. Students' recordings were additionally scored by 2 blinded experts using a validated proforma. RESULTS A total of 71 medical students were recruited. Cannulation scores improved 4.3% with DEF and 9.5% with UVF (p = 0.044), catheterization scores improved 8.7% with DEF and 8.9% with UVF (p = 0.96), and suturing improved 15.6% with DEF and 13.2% with UVF (p = 0.54). Improvement from baseline scores was significant in all cases (p < 0.05). CONCLUSION Video-assisted feedback allows a significant improvement in clinical skills for novices. No significant additional benefit was demonstrated from DEF, and a similar improvement can be obtained using a generic expert video and allowing students to review their own performance. This could have significant implications for the design and delivery of such training.
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Affiliation(s)
- Alexander W Phillips
- Northern Oesophagogastric Cancer Unit, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
| | - Joanna Matthan
- Anatomy and Clinical Skills Department, School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lucy R Bookless
- Department of General Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Ian J Whitehead
- Department of General Surgery, St Helen's and Knowsley Hospitals NHS Trust, St Helens, United Kingdom
| | - Anantha Madhavan
- Northern Oesophagogastric Cancer Unit, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Paul Rodham
- Royal Victoria Infirmary, The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Anna L R Porter
- Royal Victoria Infirmary, The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Craig I Nesbitt
- Department of Vascular Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Gerard Stansby
- Department of Vascular Surgery, Freeman Hospital, Newcastle upon Tyne, United Kingdom
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Al-Jundi W, Elsharif M, Anderson M, Chan P, Beard J, Nawaz S. A Randomized Controlled Trial to Compare e-Feedback Versus "Standard" Face-to-Face Verbal Feedback to Improve the Acquisition of Procedural Skill. JOURNAL OF SURGICAL EDUCATION 2017; 74:390-397. [PMID: 28025062 DOI: 10.1016/j.jsurg.2016.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/23/2016] [Accepted: 11/26/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Constructive feedback plays an important role in learning during surgical training. Standard feedback is usually given verbally following direct observation of the procedure by a trained assessor. However, such feedback requires the physical presence of expert faculty members who are usually busy and time-constrained by clinical commitments. We aim to evaluate electronic feedback (e-feedback) after video observation of surgical suturing in comparison with standard face-to-face verbal feedback. METHODS A prospective, blinded, randomized controlled trial comparing e-feedback with standard verbal feedback was carried out in February 2015 using a validated pro formas for assessment. The study participants were 38 undergraduate medical students from the University of Sheffield, UK. They were recorded on video performing the procedural skill, completed a self-evaluation form, and received e-feedback on the same day (group 1); observed directly by an assessor, invited to provide verbal self-reflection, and then received standard verbal feedback (group 2). In both groups, the feedback was provided after performing the procedure. The participants returned 2 days later and performed the same skill again. Poststudy questionnaire was used to assess the acceptability of each feedback among the participants. RESULTS Overall, 19 students in group 1 and 18 students in group 2 completed the study. Although there was a significant improvement in the overall mean score on the second performance of the task for all participants (first performance mean 11.59, second performance mean 15.95; p ≤ 0.0001), there was no difference in the overall mean improvement score between group 1 and group 2 (4.74 and 3.94, respectively; p = 0.49). The mean overall scores for the e-feedback group at baseline recorded by 2 independent investigators showed good agreement (mean overall scores of 12.84 and 11.89; Cronbach α = 0.86). Poststudy questionnaire demonstrated that both e-feedback and standard verbal feedback achieved high mean Likert grades as recorded by the participants (4.42 [range: 2-5] and 4.71 [range: 4-5], respectively; p = 0.274). CONCLUSION e-Feedback after watching a video recording appears to be acceptable and is not quantitatively different than standard feedback in improving suturing skills among novice trainees. Video assessment of procedural skills is reliable.
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Affiliation(s)
- Wissam Al-Jundi
- Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom.
| | - Mohamed Elsharif
- Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Melanie Anderson
- Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Phillip Chan
- Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom
| | - Jonathan Beard
- Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom
| | - Shah Nawaz
- Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom
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El Boghdady M, Alijani A. Feedback in surgical education. Surgeon 2017; 15:98-103. [DOI: 10.1016/j.surge.2016.06.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 11/25/2022]
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Mellinger JD, Williams RG, Sanfey H, Fryer JP, DaRosa D, George BC, Bohnen JD, Schuller MC, Sandhu G, Minter RM, Gardner AK, Scott DJ. Teaching and assessing operative skills: From theory to practice. Curr Probl Surg 2016; 54:44-81. [PMID: 28212782 DOI: 10.1067/j.cpsurg.2016.11.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 11/22/2016] [Indexed: 11/22/2022]
Affiliation(s)
- John D Mellinger
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL.
| | - Reed G Williams
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL; Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Hilary Sanfey
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL; American College of Surgeons, Chicago, IL
| | - Jonathan P Fryer
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Debra DaRosa
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Brian C George
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Jordan D Bohnen
- Department of General Surgery, Massachussetts General Hospital and Harvard University, Boston, MA
| | - Mary C Schuller
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Gurjit Sandhu
- Department of Surgery, University of Michigan, Ann Arbor, MI; Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI
| | - Rebecca M Minter
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Aimee K Gardner
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX; UT Southwestern Simulation Center, University of Texas Southwestern Medical Center, Dallas, TX
| | - Daniel J Scott
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX; UT Southwestern Simulation Center, University of Texas Southwestern Medical Center, Dallas, TX
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Kim SC, Fisher JG, Delman KA, Hinman JM, Srinivasan JK. Cadaver-Based Simulation Increases Resident Confidence, Initial Exposure to Fundamental Techniques, and May Augment Operative Autonomy. JOURNAL OF SURGICAL EDUCATION 2016; 73:e33-e41. [PMID: 27488813 DOI: 10.1016/j.jsurg.2016.06.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 06/12/2016] [Accepted: 06/17/2016] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Surgical simulation is an important adjunct in surgical education. The majority of operative procedures can be simplified to core components. This study aimed to quantify a cadaver-based simulation course utility in improving exposure to fundamental maneuvers, resident and attending confidence in trainee capability, and if this led to earlier operative independence. DESIGN A list of fundamental surgical procedures was established by a faculty panel. Residents were assigned to a group led by a chief resident. Residents performed skills on cadavers appropriate for PGY level. A video-recorded examination where they narrated and demonstrated a task independently was then graded by attendings using standardized rubrics. Participants completed surveys regarding improvements in knowledge and confidence. SETTING The course was conducted at the Emory University School of Medicine and the T3 Laboratories in Atlanta, GA. PARTICIPANTS A total of 133 residents and 41 attendings participated in the course. 133 (100%) participating residents and 32 (78%) attendings completed surveys. RESULTS Resident confidence in completing the assigned skill independently increased from 3 (2-3) to 4 (3-4), p < 0.01. Residents stated that a median of 40% (interquartile range: 20%-60%) of procedures were performed for the first time in the course, and the same number had been performed only in the course. The percentage of skills attendings believed residents could perform independently increased from 40% (40%-60%) to 60% (60%->80%), p < 0.04. Attendings were more likely to grant autonomy in the operating room after this exercise (4 [3-5]). CONCLUSIONS A cadaveric skills course focused on fundamental maneuvers with objective confirmation of success is a viable adjunct to clinical operative experience. Residents were formally exposed to fundamental surgical maneuvers earlier as a result of this course. This activity improved both resident and attending confidence in trainee operative skill, resulting in increased attending willingness to grant a higher level of autonomy in the operating room.
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Affiliation(s)
- Steven C Kim
- Department of Surgery, Emory University, Atlanta, Georgia
| | | | - Keith A Delman
- Department of Surgery, Emory University, Atlanta, Georgia
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Wittler M, Hartman N, Manthey D, Hiestand B, Askew K. Video-augmented feedback for procedural performance. MEDICAL TEACHER 2016; 38:607-612. [PMID: 26383586 DOI: 10.3109/0142159x.2015.1075650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Resident programs must assess residents' achievement of core competencies for clinical and procedural skills. AIMS Video-augmented feedback may facilitate procedural skill acquisition and promote more accurate self-assessment. METHODS A randomized controlled study to investigate whether video-augmented verbal feedback leads to increased procedural skill and improved accuracy of self-assessment compared to verbal only feedback. Participants were evaluated during procedural training for ultrasound guided internal jugular central venous catheter (US IJ CVC) placement. All participants received feedback based on a validated 30-point checklist for US IJ CVC placement and validated 6-point procedural global rating scale. RESULTS Scores in both groups improved by a mean of 9.6 points (95% CI: 7.8-11.4) on the 30-point checklist, with no difference between groups in mean score improvement on the global rating scale. In regards to self-assessment, participant self-rating diverged from faculty scoring, increasingly so after receiving feedback. Residents rated highly by faculty underestimated their skill, while those rated more poorly demonstrated increasing overestimation. CONCLUSIONS Accuracy of self-assessment was not improved by addition of video. While feedback advanced the skill of the resident, video-augmented feedback did not enhance skill acquisition or improve accuracy of resident self-assessment compared to standard feedback.
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Affiliation(s)
- Mary Wittler
- a Department of Emergency Medicine , Wake Forest Baptist Medical Center , USA
| | - Nicholas Hartman
- a Department of Emergency Medicine , Wake Forest Baptist Medical Center , USA
| | - David Manthey
- a Department of Emergency Medicine , Wake Forest Baptist Medical Center , USA
| | - Brian Hiestand
- a Department of Emergency Medicine , Wake Forest Baptist Medical Center , USA
| | - Kim Askew
- a Department of Emergency Medicine , Wake Forest Baptist Medical Center , USA
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Lee SG, Shin YH. Effects of Self-directed Feedback Practice using Smartphone Videos on Basic Nursing Skills, Confidence in Performance and Learning Satisfaction. J Korean Acad Nurs 2016; 46:283-92. [DOI: 10.4040/jkan.2016.46.2.283] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 10/27/2015] [Accepted: 12/23/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Seul Gi Lee
- Department of Nursing, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yun Hee Shin
- Department of Nursing, Yonsei University Wonju College of Medicine, Wonju, Korea
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Vogel D, Harendza S. Basic practical skills teaching and learning in undergraduate medical education - a review on methodological evidence. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc64. [PMID: 27579364 PMCID: PMC5003143 DOI: 10.3205/zma001063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/04/2016] [Accepted: 05/09/2016] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Practical skills are an essential part of physicians' daily routine. Nevertheless, medical graduates' performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students' learning of these skills. METHODS Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility. RESULTS 43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students' performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning. CONCLUSION A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills.
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Affiliation(s)
- Daniela Vogel
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Deutschland
| | - Sigrid Harendza
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Deutschland
- *To whom correspondence should be addressed: Sigrid Harendza, Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Martinistraße 52, D-20246 Hamburg, Deutschland, Phone: +49 (0)40/7410-5390, Fax: +49 (0)40/7410-40218, E-mail:
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Herrera-Almario GE, Kirk K, Guerrero VT, Jeong K, Kim S, Hamad GG. The effect of video review of resident laparoscopic surgical skills measured by self- and external assessment. Am J Surg 2015; 211:315-20. [PMID: 26590043 DOI: 10.1016/j.amjsurg.2015.05.039] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 04/10/2015] [Accepted: 05/26/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Video review of surgical skills is an educational modality that allows trainees to reflect on self-performance. The purpose of this study was to determine whether resident and attending assessments of a resident's laparoscopic performance differ and whether video review changes assessments. METHODS Third-year surgery residents were invited to participate. Elective laparoscopic procedures were video recorded. The Global Operative Assessment of Laparoscopic Skills evaluation was completed immediately after the procedure and again 7 to 10 days later by both resident and attending. Scores were compared using t tests. RESULTS Nine residents participated and 76 video reviews were completed. Residents scored themselves significantly lower than the faculty scores both before and after video review. Resident scores did not change significantly after video review. CONCLUSIONS Attending and resident self-assessment of laparoscopic skills differs and subsequent video review does not significantly affect Global Operative Assessment of Laparoscopic Skills scores. Further studies should evaluate the impact of video review combined with verbal feedback on skill acquisition and assessment.
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Affiliation(s)
| | - Katherine Kirk
- Department of Surgery, University of Pittsburgh Medical Center, 3380 Boulevard of the Allies Suite 390, Pittsburgh, PA, 15213, USA
| | - Veronica T Guerrero
- Department of Surgery, University of Pittsburgh Medical Center, 3380 Boulevard of the Allies Suite 390, Pittsburgh, PA, 15213, USA
| | - Kwonho Jeong
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sara Kim
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Giselle G Hamad
- Department of Surgery, University of Pittsburgh Medical Center, 3380 Boulevard of the Allies Suite 390, Pittsburgh, PA, 15213, USA.
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Nesbitt CI, Phillips AW, Searle RF, Stansby G. Randomized trial to assess the effect of supervised and unsupervised video feedback on teaching practical skills. JOURNAL OF SURGICAL EDUCATION 2015; 72:697-703. [PMID: 25703737 DOI: 10.1016/j.jsurg.2014.12.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 12/15/2014] [Accepted: 12/29/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Feedback is a vital component of the learning process; however, great variation exists in the quality, quantity, and method of delivery. Video feedback is not commonly used in the teaching of surgical skills. The aim of this trial was to evaluate the benefit of 2 types of video feedback-individualized video feedback (IVF), with the student reviewing their performance with an expert tutor, and unsupervised video-enhanced feedback (UVF), where the student reviews their own performance together with an expert teaching video-to determine if these improve performance when compared with a standard lecture feedback. METHODS A prospective blinded randomized control trial comparing lecture feedback with IVF and UVF was carried out. Students were scored by 2 experts directly observing the performance and 2 blinded experts using a validated pro forma. Participants were recorded on video when performing a suturing task. They then received their feedback via any of the 3 methods before being invited to repeat the task. RESULTS A total of 32 students were recruited between the 3 groups. There was no significant difference in suturing skill performance scores given by those directly observing the students and those blinded to the participant. There was no statistically significant difference between the 2 video feedback groups (p = 1.000), but there was significant improvement between standard lecture feedback and UVF (p = 0.047) and IVF (p = 0.001). CONCLUSION Video feedback can facilitate greater learning of clinical skills. Students can attain a similar level of surgical skills improvement with UVF as with teacher-intensive IVF.
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Affiliation(s)
- Craig I Nesbitt
- Northern Vascular Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
| | - Alexander W Phillips
- Northern Oesophagogastric Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Roger F Searle
- School of Medical Sciences Education Development, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Gerard Stansby
- Northern Vascular Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom
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