1
|
Mayer M, Isik TB, Nachtsheim L, Wolber P, Hansen KK, Grosheva M, Klussmann JP, Shabli S. Analysis of the Quality of Parotidectomy Videos on YouTube Using the IVORY-Grading-System. Laryngoscope 2023; 133:2631-2637. [PMID: 36734324 DOI: 10.1002/lary.30593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/23/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the quality and the educational content of YouTube videos showing parotidectomy. METHODS We searched for videos displaying parotidectomy on YouTube. To rate parotidectomy videos, we introduced the "Instructional Videos in Otorhinolaryngology by YO-IFOS (IVORY)-grading-system (GS)" derived from the IVORY Guidelines, which pose established consensus recommendations for the production of educational surgical videos in otolaryngology. The videos were rated using the IVORY-GS, and the total score was tested for statistical association with views, likes, likes/dislikes-ratio, age, and length of the videos for validation of the IVORY-GS. RESULTS Overall, 50 parotidectomy videos were identified. Sixty-eight (68%) of the videos showed a superficial parotidectomy. The mean IVORY-GS total score was 24.9 (out of a maximum of 44 points). Video education quality was rated as moderate in 22% and high in 4%. There was a statistically significant correlation between the total score and the number of views (p = 0.03), the total score and the number of likes (p < 0.01), and the total score and the likes/dislikes ratio (p < 0.01). A higher total score was a significant predictor of more likes (p = 0.01) and a higher likes/dislikes ratio (p < 0.01). CONCLUSION Our modification of the IVORY Guidelines is otolaryngology-specific, suitable, and recommended to evaluate parotidectomy videos. To date, most videos are of poor educational quality. Future efforts in otolaryngology surgical video education could focus on the establishment of an online video platform. LEVEL OF EVIDENCE NA Laryngoscope, 133:2631-2637, 2023.
Collapse
Affiliation(s)
- Marcel Mayer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Tarik B Isik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Lisa Nachtsheim
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Philipp Wolber
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kevin K Hansen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jens P Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Sami Shabli
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| |
Collapse
|
2
|
Cangut B, Mitchell KG, Antonoff MB. The 7 Pillars of Training Minimally Invasive Thoracic Surgery: Embracing the Virtual Era. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2023; 18:414-418. [PMID: 37743743 DOI: 10.1177/15569845231201165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Affiliation(s)
- Busra Cangut
- Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Kyle G Mitchell
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
3
|
Youssef SC, Aydin A, Canning A, Khan N, Ahmed K, Dasgupta P. Learning Surgical Skills Through Video-Based Education: A Systematic Review. Surg Innov 2023; 30:220-238. [PMID: 35968860 PMCID: PMC10280671 DOI: 10.1177/15533506221120146] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
BACKGROUND Educational videos are a potent resource for the learning of surgical skills among different study cohorts. However, there is limited evidence on the effectiveness of different educational video interventions and their features. UNLABELLED A systematic search of MEDLINE (via PubMed), Embase (via OVID), Cochrane libraries and Clinicaltrials.gov was performed from inception to 28/02/21. Studies included were not limited by date of publication, studies aiming to assess the impact of video-based interventions in the direct acquisition of surgical skill were included. Eligible studies were analysed based on study type, type of video intervention, method of assessment and period of education. The educational impact of the studies was also assessed as per Messick's framework for testing validity of evaluation methods and McGhagie's model for analysing translational outcomes. UNLABELLED 22 studies were deemed suitable for inclusion, of which 14/22 (63.6%) demonstrated a significant improvement in knowledge/skills following the video-based teaching interventions, 3/22 (13.6%) studies demonstrated an improvement in trainee satisfaction scores. A recurrent limitation of the included studies was the lack of validation of selected assessment methods. None of the included studies scored on all 5 parameters of validity as defined by Messicks validity framework. Furthermore, none of the included trials were conducted for long enough to indicate direct changes to patient outcomes resultant from educational methods. CONCLUSION Video-based surgical education is effective in learning surgical skills within different levels of surgical training; however, superior study quality and follow-up is required to determine which aspects of video-based interventions are most impactful.
Collapse
Affiliation(s)
- Samy Cheikh Youssef
- Guy’s, King’s and St Thomas’ School
of Medical Education, King’s College London, London, UK
| | - Abdullatif Aydin
- Guy’s Hospital, King’s College
London, MRC Centre for
Transplantation, London, UK
| | - Alexander Canning
- Guy’s, King’s and St Thomas’ School
of Medical Education, King’s College London, London, UK
| | - Nawal Khan
- Department of Urology, The London Clinic, London, UK
| | - Kamran Ahmed
- Guy’s Hospital, King’s College
London, MRC Centre for
Transplantation, London, UK
| | - Prokar Dasgupta
- Guy’s Hospital, King’s College
London, MRC Centre for
Transplantation, London, UK
| |
Collapse
|
4
|
Raymond M, Studer M, Al-Mulki K. Supplementing Intraoperative Mastoidectomy Teaching With Video-Based Coaching. Ann Otol Rhinol Laryngol 2023; 132:440-448. [PMID: 35658718 DOI: 10.1177/00034894221098804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Video-based coaching might complement general surgery education, but little is known of its applicability for otologic microsurgical teaching. Our purpose was thus to evaluate the content and resident-perceived benefit of video-based coaching for mastoidectomy education. METHODS In this mixed-methods pilot design, mastoidectomies were recorded from operative microscopes and reviewed during 30-minute video-based coaching sessions at 2 tertiary care centers. Eight residents and 3 attendings participated. Ten-point Likert-type questionnaires on the extent to which attendings taught 12 topics through 8 techniques were completed by residents after surgical and coaching sessions. Coaching sessions and structured interviews with residents were audio-recorded, transcribed and iteratively coded. RESULTS Seven audio-recordings were available for coaching sessions, during which a mean of 2.22 ± 0.5 topics per minute were discussed. Of the 12 teaching topics, technique was discussed most frequently (32%, 0.71 ± 0.2 topics/min), followed by anatomy (16%, 0.31 ± 0.16 topics/min). Of all 8 ratings between coaching and operative sessions, residents indicated a greater extent of discussion of anatomy (median difference, [95% confidence interval (CI)] of 3 [1-4]), progress (2.25 [95% CI, 0.5-4]), technique (3.5 [95% CI, 1.5-5.5]), pitfalls (2.5 [95% CI, 1-3.5]), and summarizing (3 [95% CI, 1-5]). In structured interviews, residents reported improved self-confidence and global perspective. CONCLUSIONS Video-based coaching is educationally dense and characterized by perceived richer teaching and promotion of a deeper surgical understanding. It requires no additional resources, can be completed in a short period of time and can be implemented programmatically for any otolaryngologic subspecialty utilizing video-recording capable equipment.
Collapse
Affiliation(s)
- Mallory Raymond
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew Studer
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Kareem Al-Mulki
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
5
|
Intraoperative video recording in otolaryngology for surgical education: evolution and considerations. J Otolaryngol Head Neck Surg 2023; 52:2. [PMID: 36658628 PMCID: PMC9851573 DOI: 10.1186/s40463-023-00620-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/02/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Otolaryngology is a surgical speciality well suited for the application of intraoperative video recording as an educational tool considering the number procedures within the speciality that utilize digital technology. Intraoperative recording has been utilized in endoscopic surgeries and in evaluating technique in mastoidectomy, myringotomy and grommet insertion. The impact of intra-operative video recording in otolaryngology education is vast in creating access to surgical videos for preparation outside the operating room to individualized coaching and assessment. The purpose of this project is to highlight the role of intraoperative video recording in otolaryngology training and elucidate the challenges and considerations associated with implementation. METHODS Related publications between 1999 to 2022 were reviewed from PubMed and Embase databases utilizing search terms "intraoperative videography," "video recording surgery," "otolaryngology," and "surgical education." 109 articles were screened independently by HB and SK, by title and abstract then full text review. 28 articles from the original search and 6 from the secondary reference review were included. RESULTS The application of intraoperative video recording is evident in otolaryngology surgeries including endoscopic sinus surgery, laryngeal surgery, and other endoscopic procedures. There have been significant advancements in recording tools, including devices that can capture the surgeon's perspective. The considerations and challenges identified with utilizing this educational tool were categorized into different themes including ethics/consent, regulation, liability, data, technology, and human resources. CONCLUSION Intra-operative video recording has been demonstrated to have significant impact within otolaryngology education. It is critical to elucidate the challenges and considerations involved to utilize this educational tool effectively. Future directives will see video-based performance analytics providing comparative metrics to encourage precise coaching of surgical residents.
Collapse
|
6
|
Shwaartz C, Reichman TW. Transplant surgeons’ perspective on antimicrobial stewardship: Experience with TransQIP. Transpl Infect Dis 2022; 24:e13950. [DOI: 10.1111/tid.13950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/17/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Chaya Shwaartz
- Department of Surgery Ajmera Transplant Program Division of General Surgery Toronto General Hospital University Health Network Toronto Ontario Canada
| | - Trevor W. Reichman
- Department of Surgery Ajmera Transplant Program Division of General Surgery Toronto General Hospital University Health Network Toronto Ontario Canada
| |
Collapse
|
7
|
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.
Collapse
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.
| |
Collapse
|
8
|
Liang S, Zhou J, Hu LL. Fun with oral radiology: Winning students over with VOTE game-based learning. J Dent Educ 2021; 85 Suppl 3:1969-1971. [PMID: 34169517 DOI: 10.1002/jdd.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/15/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Shuang Liang
- Department of Radiology, Hongqi Hospital affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang, P.R. China.,Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering, Chongqing University, Chongqing, P.R. China
| | - Jian Zhou
- Department of Radiology, Third Military Medical University, Qiqihar, Heilongjiang, P.R. China
| | - Lin-Lin Hu
- Department of Radiology, Daping Hospital, Third Military Medical University, Chongqing, P.R. China
| |
Collapse
|
9
|
Kitaguchi D, Takeshita N, Matsuzaki H, Hasegawa H, Igaki T, Oda T, Ito M. Deep learning-based automatic surgical step recognition in intraoperative videos for transanal total mesorectal excision. Surg Endosc 2021; 36:1143-1151. [PMID: 33825016 PMCID: PMC8758657 DOI: 10.1007/s00464-021-08381-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dividing a surgical procedure into a sequence of identifiable and meaningful steps facilitates intraoperative video data acquisition and storage. These efforts are especially valuable for technically challenging procedures that require intraoperative video analysis, such as transanal total mesorectal excision (TaTME); however, manual video indexing is time-consuming. Thus, in this study, we constructed an annotated video dataset for TaTME with surgical step information and evaluated the performance of a deep learning model in recognizing the surgical steps in TaTME. METHODS This was a single-institutional retrospective feasibility study. All TaTME intraoperative videos were divided into frames. Each frame was manually annotated as one of the following major steps: (1) purse-string closure; (2) full thickness transection of the rectal wall; (3) down-to-up dissection; (4) dissection after rendezvous; and (5) purse-string suture for stapled anastomosis. Steps 3 and 4 were each further classified into four sub-steps, specifically, for dissection of the anterior, posterior, right, and left planes. A convolutional neural network-based deep learning model, Xception, was utilized for the surgical step classification task. RESULTS Our dataset containing 50 TaTME videos was randomly divided into two subsets for training and testing with 40 and 10 videos, respectively. The overall accuracy obtained for all classification steps was 93.2%. By contrast, when sub-step classification was included in the performance analysis, a mean accuracy (± standard deviation) of 78% (± 5%), with a maximum accuracy of 85%, was obtained. CONCLUSIONS To the best of our knowledge, this is the first study based on automatic surgical step classification for TaTME. Our deep learning model self-learned and recognized the classification steps in TaTME videos with high accuracy after training. Thus, our model can be applied to a system for intraoperative guidance or for postoperative video indexing and analysis in TaTME procedures.
Collapse
Affiliation(s)
- Daichi Kitaguchi
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.,Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.,Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Nobuyoshi Takeshita
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| | - Hiroki Matsuzaki
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Hiro Hasegawa
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.,Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takahiro Igaki
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.,Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masaaki Ito
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. .,Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| |
Collapse
|
10
|
Sell NM, Cassidy DJ, McKinley SK, Petrusa E, Gee DW, Antonoff MB, Phitayakorn R. A Needs Assessment of Video-based Education Resources Among General Surgery Residents. J Surg Res 2021; 263:116-123. [PMID: 33652173 DOI: 10.1016/j.jss.2021.01.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/10/2021] [Accepted: 01/31/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Video-based education (VBE) is an effective tool for knowledge and skill acquisition for medical students, but its utility is less clear for resident physicians. We sought to determine how to incorporate VBE into a general surgery resident operative curriculum. METHODS We conducted a single-institution, survey-based needs assessment of general surgery residents to determine desired content and format of an operative VBE module. RESULTS The response rate was 84% (53/63), with 66% senior (postgraduate year ≥3) resident respondents. VBE was the most commonly cited resource that residents used to prepare for an operation (93%) compared with surgical textbooks (89%) and text-based website content (57%). Junior residents were more likely to utilize text-based website content than senior residents (P < 0.01). The three most important operative video components were accuracy, length, and cost. Senior residents significantly preferred videos that were peer-reviewed (P < 0.05) and featured attending surgeons whom they knew (P = 0.03). A majority of residents (59%) believed 5-10 min is the ideal length of an operative video. Across all postgraduate year levels, residents indicated that detailed instruction of each operative step was the most important content of a VBE module. Senior residents believed that the overall indications and details of each step of the operation were the most important contents of VBE for a junior resident. CONCLUSIONS At this institution, general surgery residents preferentially use VBE resources for operative preparation. A centralized, standardized operative resource would likely improve resident studying efficiency, but would require personalized learning options to work for both junior and senior surgery residents.
Collapse
Affiliation(s)
- Naomi M Sell
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Douglas J Cassidy
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Sophia K McKinley
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Denise W Gee
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
| |
Collapse
|
11
|
Noon EJR, Singh A, Hall A. What is the role of surgical simulation on operative opportunity for the trainee ENT surgeon? J Laryngol Otol 2020; 134:1-4. [PMID: 33222704 DOI: 10.1017/s0022215120002200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study sought to assess the impact of simulation training in influencing trainees' initial surgical participation as perceived by experienced surgeon trainers. METHODS Twenty ENT surgeons assessed how much of a given procedure they would expect to allow a trainee to perform for their first time. Responses were provided for trainees who had undergone a relevant simulation course and those who had not, and scored according to the eLogbook levels of involvement in surgery. This was completed for simulated procedures with validated models, across four grades of junior doctors. RESULTS A total of 1120 judgements on the trainees' intended level of involvement were made. The median involvement score was higher in the simulation group versus the non-simulation group (Mann-Whitney U, p = 0.0001), corresponding to a translation in surgical opportunity from a primarily assisting role to an active role. CONCLUSION Trainer perception of a relevant ENT simulation course appears to positively impact on the initial surgical opportunities afforded to the trainee.
Collapse
Affiliation(s)
- E J R Noon
- Department of Otolaryngology, Salford Royal Hospital, Manchester, UK
| | - A Singh
- Department of Otolaryngology, Northwick Park Hospital, Harrow, UK
| | - A Hall
- Department of Otolaryngology, Great Ormond Street Hospital, London, UK
| |
Collapse
|
12
|
Accuracy and usefulness in assessing proficiency of the observational clinical human reliability assessment checklist of the open inguinal hernia repair procedure: A cross-sectional study. Int J Surg 2020; 82:156-161. [PMID: 32882402 DOI: 10.1016/j.ijsu.2020.08.032] [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: 06/10/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND The Observational Clinical Human Reliability Assessment (OCHRA) can be used to score errors during surgical procedures. To construct an OCHRA-checklist, steps, substeps, and hazards of a surgical procedure need to be defined. A step-by-step framework was developed to segment surgical procedures into steps, substeps, and hazards. The first aim of this study was to investigate if the step-by-step framework could be used to construct an accurate Lichtenstein open inguinal hernia repair (LOIHR) stepwise description. The second aim was to investigate if the OCHRA-checklist based on this stepwise description was accurate and useful for surgical training and assessment. MATERIALS AND METHODS Ten expert surgeons rated statements regarding the accuracy of the LOIHR stepwise description, the accuracy, and the usefulness of the LOIHR OCHRA-checklist (eight, seven, and six statements, respectively) using a 5-point Likert scale. One-sample Wilcoxon signed-rank test was used to compare the outcomes to the neutral value of 3. RESULTS The accuracy of the stepwise description and the accuracy and usefulness of the OCHRA-checklist were rated statistically significantly higher than the neutral value of 3 (median 4.75 [5.00-4.00] with p = .009, median 5.00 [5.00-4.00] with p = .012, median 4.00 [5.00-4.00] with p = .047, respectively). The experts rated the OCHRA-checklist to be useful for the training (5.00 [5.00-4.00], p = .009), and assessment (4.50 [5.00-4.00], p = .010) of surgical residents. CONCLUSION This preliminary study showed that the stepwise LOIHR description constructed using the step-by-step framework was found to be accurate. The LOIHR OCHRA-checklist developed using the stepwise description was also accurate, and particularly useful for the training and assessment of proficiency of surgical residents.
Collapse
|
13
|
Simon F, Peer S, Michel J, Bruce IA, Cherkes M, Denoyelle F, Fagan JJ, Harish M, Hong P, James A, Jia H, Krishnan PV, Maunsell R, Modi VK, Nguyen Y, Parikh SR, Patel N, Pullens B, Russo G, Rutter MJ, Sargi Z, Shaye D, Sowerby LJ, Yung M, Zdanski CJ, Teissier N, Fakhry N. IVORY Guidelines (Instructional Videos in Otorhinolaryngology by YO-IFOS): A Consensus on Surgical Videos in Ear, Nose, and Throat. Laryngoscope 2020; 131:E732-E737. [PMID: 33270236 PMCID: PMC7891442 DOI: 10.1002/lary.29020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 11/16/2022]
Abstract
Objectives/Hypothesis Otolaryngology instructional videos available online are often of poor quality. The objective of this article was to establish international consensus recommendations for the production of educational surgical videos in otolaryngology. Study Design DELPHI survey. Methods Twenty‐seven international respondents participated in this study from 12 countries. Consensus was reached after three rounds of questionnaires following the Delphi methodology. The proposals having reached the 80% agreement threshold in the third round were retained. Results The main recommendations are as follows: 1) Ethics: patients must be anonymized and unrecognizable (apart from plastic surgery if necessary). A signed authorization must be obtained if the person is recognizable. 2) Technical aspects: videos should be edited and in high‐definition (HD) quality if possible. Narration or subtitles and didactic illustrations are recommended. 3) Case presentation: name of pathology and procedure must be specified; the case should be presented with relevant workup. 4) Surgery: surgical procedures should be divided into several distinct stages and include tips and pitfalls. Pathology should be shown if relevant. Key points should be detailed at the end of the procedure. 5) Organ‐specific: type of approach and bilateral audiometry should be specified in otology. Coronal plane computed tomography scans should be shown in endonasal surgery. It is recommended to show pre‐ and postoperative videos in voice surgery and preoperative drawings and photos of scars in plastic surgery, as well as the ventilation method in airway surgery. Conclusions International recommendations have been determined to assist in the creation and standardization of educational surgical videos in otolaryngology and head and neck surgery. Level of Evidence 5 Laryngoscope, 131:E732–E737, 2021
Collapse
Affiliation(s)
- François Simon
- Department of Pediatric Otolaryngology, Necker-Sick Children's Hospital, AP-HP-University of Paris, Paris, France
| | - Shazia Peer
- Division of Otolaryngology, University of Cape Town and Red Cross Children's Hospital, Rondebosch, South Africa
| | - Justin Michel
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Aix Marseille University, APHM, University Institute of Industrial Thermal Systems, La Conception University Hospital, Marseille, France
| | - Iain A Bruce
- Division of Infection, Immunity, and Respiratory Medicine, Royal Manchester Children's Hospital, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Maryana Cherkes
- Departement of Otolaryngology, Lviv City Children's Clinical Hospital, Lviv National Medical University, Lviv, Ukraine
| | - Françoise Denoyelle
- Department of Pediatric Otolaryngology, Necker-Sick Children's Hospital, AP-HP-University of Paris, Paris, France
| | - Johannes J Fagan
- Division of Otolaryngology, University of Cape Town and Red Cross Children's Hospital, Rondebosch, South Africa
| | | | - Paul Hong
- Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Adrian James
- Department of Otolaryngology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Huan Jia
- Department of Otolaryngology-Head Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - P Vijaya Krishnan
- Department of Otorhinolaryngology, Madras Ear Nose and Throat Research Foundation, Chennai, Tamil Nadu, India
| | - Rebecca Maunsell
- Department of Otorhinolaryngology, Faculty of Medical Sciences, State University of Campinas UNICAMP, Campinas, Brazil
| | - Vikash K Modi
- Pediatric Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, New York, U.S.A
| | - Yann Nguyen
- Department of Otorhinolaryngology, Pitié-Salpêtrière Hospital, Robotic and surgical innovation research group, Inserm, Pasteur, "Innovative Technologies and Translational Therapeutics for Deafness," Hearing Institute, Sorbonne University, AP-HP, Paris, France
| | - Sanjay R Parikh
- Seattle Children's Hospital, University of Washington, Seattle, Washington, U.S.A
| | - Nirmal Patel
- Department of Otolaryngology-Head and Neck Surgery, University of Sydney and Macquarie University, Sydney, New South Wales, Australia
| | - Bas Pullens
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Gennaro Russo
- Department of Otorhinolaryngology, Monaldi Hospital, Naples, Italy
| | - Michael J Rutter
- Division of Pediatric Otolaryngology, Aerodigestive and Esophageal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Zoukaa Sargi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - David Shaye
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Leigh J Sowerby
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Matthew Yung
- Department of Otolaryngology, Ipswich Hospital, Colchester, United Kingdom
| | - Carlton J Zdanski
- Division of Pediatric Otolaryngology/Head and Neck Surgery, Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A
| | - Natacha Teissier
- Department of Pediatric Otolaryngology, Robert-Debré Hospital, AP-HP-University of Paris, Paris, France
| | - Nicolas Fakhry
- Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Aix Marseille University, APHM, Language and Speech Laboratory, La Conception University Hospital, Marseille, France
| |
Collapse
|
14
|
Objective assessment of surgical operative performance by observational clinical human reliability analysis (OCHRA): a systematic review. Surg Endosc 2020; 34:1492-1508. [PMID: 31953728 PMCID: PMC7093355 DOI: 10.1007/s00464-019-07365-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/24/2019] [Indexed: 12/15/2022]
Abstract
Background Both morbidity and mortality data (MMD) and learning curves (LCs) do not provide information on the nature of intraoperative errors and their mechanisms when these adversely impact on patient outcome. OCHRA was developed specifically to address the unmet surgical need for an objective assessment technique of the quality of technical execution of operations at individual operator level. The aim of this systematic review was to review of OCHRA as a method of objective assessment of surgical operative performance. Methods Systematic review based on searching 4 databases for articles published from January 1998 to January 2019. The review complies with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and includes original publications on surgical task performance based on technical errors during operations across several surgical specialties. Results Only 26 published studies met the search criteria, indicating that the uptake of OCHRA during the study period has been low. In 31% of reported studies, the operations were performed by fully qualified consultant/attending surgeons and by surgical trainees in 69% in approved training programs. OCHRA identified 7869 consequential errors (CE) during the conduct of 719 clinical operations (mean = 11 CEs). It also identified ‘hazard zones’ of operations and proficiency–gain curves (P-GCs) that confirm attainment of persistent competent execution of specific operations by individual trainee surgeons. P-GCs are both surgeon and operation specific. Conclusions Increased OCHRA use has the potential to improve patient outcome after surgery, but this is a contingent progress towards automatic assessment of unedited videos of operations. The low uptake of OCHRA is attributed to its labor-intensive nature involving human factors (cognitive engineering) expertise. Aside from faster and more objective peer-based assessment, this development should accelerate increased clinical uptake and use of the technique in both routine surgical practice and surgical training.
Collapse
|
15
|
Abstract
INTRODUCTION Skill in bariatric surgery has been associated with postoperative outcome. Appropriate surgical training is of paramount importance. In order to continuously improve training strategies, it is necessary to assess current practices. AIM To determine how German bariatric surgeons have been trained and to assess current training strategies. METHODS Between February 2017 and March 2017, an online census of surgeons registered as members of the German Society for Bariatric and Metabolic Surgery was conducted. A total of three reminders were sent out. Data were analyzed using descriptive statistics. Data was reported as median (interquartile range); percentages were adjusted for completed answers only. RESULTS A response rate of 51% (n = 214) was achieved. Surgeons reported a median of 14.5 (8-20) years of surgical experience after initial training, with a specific bariatric experience of 7 (4-13) years. The total cumulative bariatric case volume was 240 (80-500) cases, with an annual case volume of 50 (25-80). The most commonly applied approaches to bariatric skills acquisition were "learning by doing" (71%), "course participation" (70%) and "observerships" (70%). Fellowships and the use of operating videos were less frequently applied strategies (19%/ 47%). Interestingly, observerships (94%) and course participation (89%) were rated as very important/important, whereas "learning by doing" (62%), watching operation videos (59%), and fellowships (48%) were less frequently perceived as important/very important training strategies. CONCLUSIONS The majority of surgeons performing bariatric cases were senior surgeons with more than 10 years of post-training experience; nevertheless, the survey revealed a lack of structured approaches to bariatric specialization training.
Collapse
|
16
|
Saun TJ, Zuo KJ, Grantcharov TP. Video Technologies for Recording Open Surgery: A Systematic Review. Surg Innov 2019; 26:599-612. [PMID: 31165687 DOI: 10.1177/1553350619853099] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Video recording of surgical procedures is an important tool for surgical education, performance enhancement, and error analysis. Technology for video recording open surgery, however, is limited. The objective of this article is to provide an overview of the available literature regarding the various technologies used for intraoperative video recording of open surgery. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines using the MEDLINE, Cochrane Central, and EMBASE databases. Two authors independently screened the titles and abstracts of the retrieved articles, and those that satisfied the defined inclusion criteria were selected for a full-text review. A total of 2275 publications were initially identified, and 110 were included in the final review. The included articles were categorized based on type of article, surgical subspecialty, type and positioning of camera, and limitations identified with their use. The most common article type was primary-technical (29%), and the dominant specialties were general surgery (22%) and plastic surgery (18%). The most commonly cited camera used was the GoPro (30%) positioned in a head-mount configuration (60%). Commonly cited limitations included poor video quality, inadequate battery life, light overexposure, obstruction by surgical team members, and excessive motion. Open surgery remains the mainstay of many surgical specialties today, and technological innovation is absolutely critical to fulfill the unmet need for better video capture of open surgery. The findings of this article will be valuable for guiding future development of novel technology for this purpose.
Collapse
Affiliation(s)
- Tomas J Saun
- 1 St Michael's Hospital, Toronto, ON, Canada.,2 University of Toronto, ON, Canada
| | | | | |
Collapse
|
17
|
Reck-Burneo CA, Dingemans AJM, Lane VA, Cooper J, Levitt MA, Wood RJ. The Impact of Manuscript Learning vs. Video Learning on a Surgeon's Confidence in Performing a Difficult Procedure. Front Surg 2018; 5:67. [PMID: 30483511 PMCID: PMC6240588 DOI: 10.3389/fsurg.2018.00067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/17/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: Operative surgical videos are a popular educational resource, not commonly a part of a peer-reviewed article. We wanted to evaluate the impact of either reading a peer-reviewed manuscript or watching an operative video on a surgeon's confidence in performing a complex case. Methods: Pediatric surgeons and fellows were asked to complete an initial questionnaire to assess their confidence (formulated as a score) in the diagnosis and operative repair of anal stenosis and rectal atresia. Results: Of 101 pediatric surgeons and fellows, 52 (51%) were randomized into a "manuscript" group and 49 (49%) into a "video" group. The mean confidence before the intervention was the same in the two groups (6.4 vs. 6.6). Attending surgeons started with more confidence than trainees (7.1 vs. 5.3, p < 0.001). In the manuscript group, the average confidence increased to 7.7 (p = 0.005), and in the video group the average confidence increased to 7.9 (p = 0.001) globally. Trainees in the video group significantly improved their confidence to a score of 6.6 (p = 0.035), as did attending surgeons to 8.5 (p = 0.01). In the manuscript group, only attendings significantly improved their confidence by 1.5-8.3 (p < 0.001), whereas trainees did not with a difference of 1.3 (p = 0.194). When considering experience level, physicians who reported never having performed this surgery improved only by reading the manuscript (3.9-6.2) (p = 0.004), not by watching the video (5.4-6.6) (p = 0.106). Surgeons with experience doing this operation (>5 times) did not improve their confidence by reading the manuscript (p = 0.10), nor by watching the video (p = 0.112). Conclusion: Reviewing either a detailed manuscript or operative video on the surgical management of rectal atresia and anal stenosis demonstrated a significant increase in self-reported confidence. Trainees benefitted the most from operative videos, whereas experienced surgeons did not improve their confidence by reading the manuscript nor watching the video.
Collapse
Affiliation(s)
- Carlos A Reck-Burneo
- Center for Colorectal and Pelvic Reconstruction (CCPR), Nationwide Children's Hospital, Columbus, OH, United States.,Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Alexander J M Dingemans
- Center for Colorectal and Pelvic Reconstruction (CCPR), Nationwide Children's Hospital, Columbus, OH, United States
| | - Victoria A Lane
- Center for Colorectal and Pelvic Reconstruction (CCPR), Nationwide Children's Hospital, Columbus, OH, United States
| | - Jennifer Cooper
- Center for Colorectal and Pelvic Reconstruction (CCPR), Nationwide Children's Hospital, Columbus, OH, United States
| | - Marc A Levitt
- Center for Colorectal and Pelvic Reconstruction (CCPR), Nationwide Children's Hospital, Columbus, OH, United States
| | - Richard J Wood
- Center for Colorectal and Pelvic Reconstruction (CCPR), Nationwide Children's Hospital, Columbus, OH, United States
| |
Collapse
|