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Halim F, Widysanto A, Wahjoepramono POP, Candrawinata VS, Budihardja AS, Irawan A, Sudirman T, Christina N, Koerniawan HS, Tobing JFL, Sungono V, Marlina M, Wahjoepramono EJ. Objective Comparison of the First-Person-View Live Streaming Method Versus Face-to-Face Teaching Method in Improving Wound Suturing Skills for Skin Closure in Surgical Clerkship Students: Randomized Controlled Trial. JMIR MEDICAL EDUCATION 2024; 10:e52631. [PMID: 39291977 DOI: 10.2196/52631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 06/02/2024] [Accepted: 08/02/2024] [Indexed: 09/19/2024]
Abstract
Background The use of digital online teaching media in improving the surgical skills of medical students is indispensable, yet it is still not widely explored objectively. The first-person-view online teaching method may be more effective as it provides more realism to surgical clerkship students in achieving basic surgical skills. Objective This study aims to objectively assess the effectiveness of the first-person-view live streaming (LS) method using a GoPro camera compared to the standard face-to-face (FTF) teaching method in improving simple wound suturing skills in surgical clerkship students. Methods A prospective, parallel, nonblinded, single-center, randomized controlled trial was performed. Between January and April 2023, clerkship students of the Department of Surgery, Pelita Harapan University, were randomly selected and recruited into either the LS or FTF teaching method for simple interrupted suturing skills. All the participants were assessed objectively before and 1 week after training, using the direct observational procedural skills (DOPS) method. DOPS results and poststudy questionnaires were analyzed. Results A total of 74 students were included in this study, with 37 (50%) participants in each group. Paired analysis of each participant's pre-experiment and postexperiment DOPS scores revealed that the LS method's outcome is comparable to the FTF method's outcome (LS: mean 27.5, SD 20.6 vs FTF: mean 24.4, SD 16.7; P=.48) in improving the students' surgical skills. Conclusions First-person-view LS training sessions could enhance students' ability to master simple procedural skills such as simple wound suturing and has comparable results to the current FTF teaching method. Teaching a practical skill using the LS method also gives more confidence for the participants to perform the procedure independently. Other advantages of the LS method, such as the ability to study from outside the sterile environment, are also promising. We recommend improvements in the audiovisual quality of the camera and a stable internet connection before performing the LS teaching method.
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Affiliation(s)
- Freda Halim
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Boulevard Jenderal Sudirman, Faculty of Medicine Building, 2nd Floor, Tangerang, 15811, Indonesia, 62 541-10130, 62 542-05025
| | - Allen Widysanto
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
| | | | - Valeska Siulinda Candrawinata
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Boulevard Jenderal Sudirman, Faculty of Medicine Building, 2nd Floor, Tangerang, 15811, Indonesia, 62 541-10130, 62 542-05025
| | - Andi Setiawan Budihardja
- Department of Oral Maxillofacial Surgery, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
| | - Andry Irawan
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Boulevard Jenderal Sudirman, Faculty of Medicine Building, 2nd Floor, Tangerang, 15811, Indonesia, 62 541-10130, 62 542-05025
| | - Taufik Sudirman
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Boulevard Jenderal Sudirman, Faculty of Medicine Building, 2nd Floor, Tangerang, 15811, Indonesia, 62 541-10130, 62 542-05025
| | - Natalia Christina
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Boulevard Jenderal Sudirman, Faculty of Medicine Building, 2nd Floor, Tangerang, 15811, Indonesia, 62 541-10130, 62 542-05025
| | - Heru Sutanto Koerniawan
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Boulevard Jenderal Sudirman, Faculty of Medicine Building, 2nd Floor, Tangerang, 15811, Indonesia, 62 541-10130, 62 542-05025
| | - Jephtah Furano Lumban Tobing
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
| | - Veli Sungono
- Department of Public Health, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
| | - Mona Marlina
- Department of Medical Education, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
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Howie EE, Harari R, Dias RD, Wigmore SJ, Skipworth RJE, Yule S. Feasibility of Wearable Sensors to Assess Cognitive Load During Clinical Performance: Lessons Learned and Blueprint for Success. J Surg Res 2024; 302:222-231. [PMID: 39106733 DOI: 10.1016/j.jss.2024.07.009] [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: 03/01/2024] [Revised: 05/23/2024] [Accepted: 07/02/2024] [Indexed: 08/09/2024]
Abstract
INTRODUCTION Cognitive load (CogL) is increasingly recognized as an important resource underlying operative performance. Current innovations in surgery aim to develop objective performance metrics via physiological monitoring from wearable digital sensors. Surgeons have access to consumer technology that could measure CogL but need guidance regarding device selection and implementation. To realize the benefits of surgical performance improvement these methods must be feasible, incorporating human factors usability and design principles. This paper aims to evaluate the feasibility of using wearable sensors to assess CogL, identify the benefits and challenges of implementing devices, and develop guidance for surgeons planning to implement wearable devices in their research or practice. METHODS We examined the feasibility of wearable sensors from a series of empirical studies that measured aspects of clinical performance relating to CogL. Across four studies, 84 participants and five sensors were involved in the following clinical settings: (i) real intraoperative surgery; (ii) simulated laparoscopic surgery; and (iii) medical team performance outside the hospital. RESULTS Wearable devices worn on the wrist and chest were found to be comfortable. After a learning curve, electrodermal activity data were easily and reliably collected. Devices using photoplethysmography to determine heart rate variability were significantly limited by movement artifact. There was variable success with electroencephalography devices regarding connectivity, comfort, and usability. CONCLUSIONS It is feasible to use wearable sensors across various clinical settings, including surgery. There are some limitations, and their implementation is context and device dependent. To scale sensor use in clinical research, surgeons must embrace human factors principles to optimize wearability, usability, reliability, and data security.
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Affiliation(s)
- Emma E Howie
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland.
| | - Ryan Harari
- Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland; STRATUS Centre for Medical Simulation, Brigham & Women's Hospital, Boston, Massachusetts; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Roger D Dias
- Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland; STRATUS Centre for Medical Simulation, Brigham & Women's Hospital, Boston, Massachusetts; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Stephen J Wigmore
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland
| | - Richard J E Skipworth
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland
| | - Steven Yule
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland.
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Lee SH, Riney LC, Merkt B, McDonough SD, Baker J, Boyd S, Zhang Y, Geis GL. Improving Pediatric Procedural Skills for EMS Clinicians: A Longitudinal Simulation-Based Curriculum with Novel, Remote, First-Person-View Video-Based Outcome Measurement. PREHOSP EMERG CARE 2024; 28:352-362. [PMID: 37751212 DOI: 10.1080/10903127.2023.2263555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/21/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Emergency medical services (EMS) clinicians are expected to provide expert care to all patients, but face obstacles in maintaining skillsets required in the care of critically ill or injured children. The objectives of this study were to describe and assess the effectiveness of a pediatric-focused, simulation-based, procedural training program for EMS clinicians, delivered on-site by a pediatric simulation education team. We also describe a novel, remote, asynchronous performance outcome measurement system using first-person-view video review. METHODS This was a prospective study of simulation-based training and procedural outcomes. The study population involved EMS clinicians at three fire-based EMS agencies stratified as urban, suburban, and rural sites. The primary outcome was performance of intraosseous catheterization (IO), bag-valve-mask ventilation (BVM), and supraglottic device placement (SGD), measured across three time points. Secondary outcomes were identification of differences across EMS agencies and participant survey responses. RESULTS We obtained video data from 122 clinicians, totaling 561 videos, with survey response rates of 89.0-91.3%. Pre-intervention scores were high: least-square means (95% confident-intervals) 9.5 (8.9, 10.2) for IO; 9.6 (9.3, 9.9) for BVM; and 11.6 (10.9, 12.2) for SGD. There was significant improvement post-intervention: 11.5 (10.7, 12.3) for IO; 11.0 (10.7, 11.4) for BVM; and 13.6 (12.8, 14.4) for SGD. Improvement was maintained at follow-up after a median of 9.5 months: 10.5 (9.8, 11.2) for IO; 10.2 (9.9, 10.6) for BVM; and 12.4 (11.7, 13.1) for SGD. There were no statistical differences between sites. Of survey respondents, half had not cared for a critically ill or injured child in at least a year, the vast majority had not had hands-on pediatric training in over 6 months, and the majority felt that training should occur at least every 6 months. CONCLUSIONS Our pediatric-focused, simulation-based procedural training program was associated with improvement and maintenance of high-baseline procedural performance for EMS clinicians over the study period. Findings were consistent across sites. Remote assessment was feasible. Participant surveys emphasized a desire for more pediatric-focused training and highlighted the low frequency of clinical exposure to procedures potentially needed in the care of critically ill or injured pediatric patients.
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Affiliation(s)
- Sang Hoon Lee
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, USA
| | - Lauren C Riney
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, USA
| | - Brant Merkt
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Shawn D McDonough
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Jordan Baker
- Division of Pediatric Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Stephanie Boyd
- Division of Pediatric Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Yin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Gary L Geis
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, USA
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Felsenreich DM, Yang W, Taskin HE, Abdelbaki T, Shahabi S, Zakeri R, Talishinskiy T, Gero D, Neimark A, Chiappetta S. Young-IFSO Bariatric/Metabolic Surgery Training and Education Survey. Obes Surg 2023; 33:2816-2830. [PMID: 37505341 DOI: 10.1007/s11695-023-06751-8] [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] [Received: 04/08/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND This international Young-IFSO survey aims to address variations, trends, and obstacles in bariatric/metabolic surgery (BMS) training globally, since expectations and resources differ among young surgeons. METHODS The Young-IFSO scientific team designed an online confidential questionnaire with 50 questions analyzing the individual BMS training. The survey link was sent to all IFSO/ASMBS members and was shared in social media. All Young-IFSO members (age up to 45 years) were invited to participate between 16 December 2022 and 4 February 2023. RESULTS A total of 240 respondents from 61 countries took the survey. Most respondents (70.24%) described their current position as a consultant surgeon with an average of 5.43 years' experience working in BMS, and 55% are working in a bariatric center of excellence. More than 50% of the respondents performed none or less than 10 BMS during residency. Preparation of the stomach and stapling during sleeve gastrectomy (SG) were the first steps performed, and SG was the first BMS completed as a first operating surgeon by most of the respondents (74%). In total, 201 (84.45%) surgeons reported to perform scientific work. Most respondents (90.13%) reported that surgical mentorship had improved their surgical skills. CONCLUSION This international experts' survey underlines the lack of a standardized global surgical curriculum of BMS during residency. It shows that SG is the single most performed procedure by young surgeons. These data might underline the importance of advancing surgical education in BMS, and accredited fellowship programs should be offered globally to maintain and raise quality of BMS.
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Affiliation(s)
- Daniel M Felsenreich
- Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Halit E Taskin
- Bariatric Surgery Center, Department of Surgery, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tamer Abdelbaki
- General Surgery Department, Alexandria University, Faculty of Medicine, Alexandria, Egypt
| | - Shahab Shahabi
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Roxanna Zakeri
- Department of Upper GI Surgery, University College London Hospital NHS Foundation Trust, London, UK
| | - Toghrul Talishinskiy
- Bariatric Surgery Minimally Invasive and Robotic Surgery, St. Joseph's University Medical Center, Paterson, USA
| | - Daniel Gero
- Department of Surgery and Transplantation, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexandr Neimark
- Almazov National Medical Research Centre, Saint-Petersburg, Russia
| | - Sonja Chiappetta
- Bariatric and Metabolic Surgery Unit, Department of General Surgery, Ospedale Evangelico Betania, Via Argine 604, 80147, Naples, Italy.
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Al-Hubaishi O, Hillier T, Gillis M, Oxner W, Trenholm A, Richardson G, Leighton R, Glennie A. Video-based assessment (VBA) of an open, simulated orthopedic surgical procedure: a pilot study using a single-angle camera to assess surgical skill and decision making. J Orthop Surg Res 2023; 18:90. [PMID: 36750893 PMCID: PMC9904250 DOI: 10.1186/s13018-023-03557-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/21/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Videos have been used in many settings including medical simulation. Limited information currently exists on video-based assessment in surgical training. Effective assessment tools have substantial impact on the future of training. The objectives of this study were as follows: to evaluate the inter-rater reliability of video-based assessment of orthopedic surgery residents performing open cadaveric simulation procedures and to explore the benefits and limitations of video-based assessment. METHODS A multi-method technique was used. In the quantitative portion, four residents participated in a Surgical Objective Structured Clinical Examination in 2017 at a quaternary care training center. A single camera bird's-eye view was used to videotape the procedures. Five orthopedic surgeons evaluated the surgical videos using the Ottawa Surgical Competency Operating Room Evaluation. Interclass correlation coefficient was used to calculate inter-rater reliability. In the qualitative section, semi-structured interviews were used to explore the perceived strengths and limitations of video-based assessment. RESULTS AND DISCUSSION The scores using video-based assessment demonstrated good inter-rater reliability (ICC = 0.832, p = 0.014) in assessing open orthopedic procedures on cadavers. Qualitatively, the strengths of video-based assessment in this study are its ability to assess global performance and/or specific skills, ability to reassess missed points during live assessment, and potential use for less common procedures. It also allows for detailed constructive feedback, flexible assessment time, anonymous assessment, multiple assessors and serves as a good coaching tool. The main limitations of video-based assessment are poor audio-video quality, and questionable feasibility for assessing readiness for practice. CONCLUSION Video-based assessment is a potential adjunct to live assessment in orthopedic open procedures with good inter-rater reliability. Improving audio-video quality will enhance the quality of the assessment and improve the effectiveness of using this tool in surgical training.
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Affiliation(s)
- Obaid Al-Hubaishi
- grid.55602.340000 0004 1936 8200Department of Surgery, Dalhousie University, Halifax, NS Canada
| | - Troy Hillier
- grid.55602.340000 0004 1936 8200Faculty of Medicine, Dalhousie University, Halifax, NS Canada
| | - Megan Gillis
- grid.55602.340000 0004 1936 8200Department of Surgery, Dalhousie University, Halifax, NS Canada
| | - William Oxner
- grid.55602.340000 0004 1936 8200Department of Surgery, Dalhousie University, Halifax, NS Canada
| | - Andrew Trenholm
- grid.55602.340000 0004 1936 8200Department of Surgery, Dalhousie University, Halifax, NS Canada
| | - Glen Richardson
- grid.55602.340000 0004 1936 8200Department of Surgery, Dalhousie University, Halifax, NS Canada
| | - Ross Leighton
- grid.55602.340000 0004 1936 8200Department of Surgery, Dalhousie University, Halifax, NS Canada
| | - Andrew Glennie
- Department of Surgery, Dalhousie University, Halifax, NS, Canada.
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Operative Coaching for General Surgery Residents: Review of Implementation Requirements. J Am Coll Surg 2022; 235:361-369. [PMID: 35839415 DOI: 10.1097/xcs.0000000000000217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Operative coaching offers a unique opportunity to strengthen surgery residents' skill sets and practice readiness. However, institutional organizational capacity may influence the ability to successfully implement and sustain a coaching program. This review concentrates on the implementation requirements as they relate to institutional organizational capacity to help evaluate and determine if adopting such a coaching model is feasible. We searched English-language, peer-reviewed articles concerning operative coaching of general surgery residents between 2000 and 2020 with the MEDLINE database. The abstracts of 267 identified articles were further screened based on the presence of 2 inclusion criteria: general surgery residents and operative coaching. Then we summarized the reported implementation requirements. Findings revealed the implementation requirements (ie people, processes, technology/support resources, physical resources, and organizational systems) of 3 major types of resident operative coaching models were different. Video-assisted coaching faces the most barriers to implementation followed by video-based coaching; in-person coaching encounters the least barriers. Six questions are generated helping residency education leaders assess their readiness for an operative coaching program. Evaluation of the implementation requirements of a desired coaching program using the 5 organizational capacity elements is recommended to ensure the residency's ability to achieve a successful and sustainable program.
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Mullen JR, Srinivasan RC, Tuckman DV, Hammert WC. How to Shoot and Edit High-Quality Surgical Videos for Hand and Upper Extremity Surgery. J Hand Surg Am 2022; 47:471-474. [PMID: 34903392 DOI: 10.1016/j.jhsa.2021.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 08/01/2021] [Accepted: 09/17/2021] [Indexed: 02/02/2023]
Abstract
A surgical video can improve patient care, surgical education, as well as scientific presentations and publications. Previous authors have outlined a basic understanding of how to produce high-quality surgical videos. With continuous technological improvements in video-filming hardware and editing software, multiple options for producing high-quality surgical videos are available. This article described important aspects of filming and editing videos to create a video that the surgeon can watch before performing the procedure. The authors reviewed camera terminology, including resolution, optical and digital zoom, shutter speed, and frame rate, as well as equipment options or setup for recording high-quality surgical videos. We provided information regarding computer requirements and editing on Windows and Macintosh operating systems, optimizing educational value for the viewer.
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Affiliation(s)
| | - Ramesh C Srinivasan
- Department of Orthopaedic Surgery, The Hand Center of San Antonio, University of Texas, San Antonio, TX
| | | | - Warren C Hammert
- Department of Orthopaedic Surgery, University of Rochester, Rochester, NY.
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Esposito AC, Coppersmith NA, White EM, Yoo PS. Video Coaching in Surgical Education: Utility, Opportunities, and Barriers to Implementation. JOURNAL OF SURGICAL EDUCATION 2022; 79:717-724. [PMID: 34972670 DOI: 10.1016/j.jsurg.2021.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/30/2021] [Accepted: 12/04/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This review discusses the literature on Video-Based Coaching (VBC) and explores the barriers to widespread implementation. DESIGN A search was performed on Scopus and PubMed for the terms "operation," "operating room," "surgery," "resident," "house staff," "graduate medical education," "teaching," "coaching," "assessment," "reflection," "camera," and "video" on July 27, 2021, in English. This yielded 828 results. A single author reviewed the titles and abstracts and eliminated any results that did not pertain to operative VBC or assessment. All bibliographies were reviewed, and appropriate manuscripts were included in this study. This resulted in a total of 52 manuscripts included in this review. SETTING/PARTICIPANTS Original, peer-reviewed studies focused on VBC or assessment. RESULTS VBC has been both subjectively and objectively found to be a valuable educational tool. Nearly every study of video recording in the operating room found that subjects, including surgical residents and seasoned surgeons alike, overwhelmingly considered it a useful, non-redundant adjunct to their training. Most studies that evaluated skill acquisition via standardized assessment tools found that surgical residents who underwent a VBC program had significant improvements compared to their counterparts who did not undergo video review. Despite this evidence of effectiveness, fewer than 5% of residency programs employ video recording in the operating room. Barriers to implementation include significant time commitments for proposed coaching curricula and difficulty with integration of video cameras into the operating room. CONCLUSIONS VBC has significant educational benefits, but a scalable curriculum has not been developed. An optimal solution would ensure technical ease and expediency, simple, high-quality cameras, immediate review, and overcoming entrenched surgical norms and culture.
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Affiliation(s)
- Andrew C Esposito
- Yale School of Medicine, Department of Surgery, New Haven, Connecticut
| | | | - Erin M White
- Yale School of Medicine, Department of Surgery, New Haven, Connecticut
| | - Peter S Yoo
- Yale School of Medicine, Department of Surgery, New Haven, Connecticut.
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Kava L, Jones K, Ehrman R, Smylie L, McRae M, Dubey E, Reed B, Messman A. Video-assisted self-reflection of resuscitations for resident education and improvement of leadership skills: A pilot study. PERSPECTIVES ON MEDICAL EDUCATION 2022; 11:80-85. [PMID: 34783998 PMCID: PMC8940988 DOI: 10.1007/s40037-021-00690-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION One of the most challenging aspects of Emergency Medicine (EM) residency is mastering the leadership skills required during a resuscitation. Use of resuscitation video recording for debriefing is gaining popularity in graduate medical education. However, there are limited studies of how video technology can be used to improve leadership skills in the emergency department. We aim to evaluate the utility of video-assisted self-reflection, compared with self-reflection alone, in the setting of resuscitation leadership. METHODS This was a prospective, randomized, controlled pilot study conducted in 2018 at an urban level 1 trauma center with a three-year EM residency program. The trial included postgraduate year (PGY) 2 and 3 residents (n = 10). Each resident acted as an individual team leader for a live real-time resuscitation in the emergency department. The authors classified a patient as a resuscitation if there was an immediate life- or limb-threatening disease process or an abnormal vital sign with an indication of hypoperfusion. Each resident was recorded as the team leader twice. Both control and intervention groups produced written self-reflection after their first recording. The intervention group viewed their resuscitation recording while completing the written reflection. After their reflection, all participants were recorded for a second resuscitation. Two faculty experts, blinded to the study, scored each video using the Concise Assessment of Leader Management (CALM) scale to measure the leadership skills of the resident team leader. RESULTS Five PGY‑3 and five PGY‑2 residents participated. The weighted kappa between the two experts was 0.45 (CI 0.34-0.56, p < 0.0001). The median gain score in the control group was -1.5 (IQR) versus 0.5 in the intervention group (IQR). DISCUSSION Video-assisted self-reflection showed positive gain score trends in leadership evaluation for residents during a resuscitation compared with the non-video assisted control group. This tool would be beneficial to implement in EM residency.
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Affiliation(s)
| | - Kerin Jones
- Detroit Receiving Hospital, Detroit, MI, USA
| | | | | | | | | | - Brian Reed
- Detroit Receiving Hospital, Detroit, MI, USA
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Bräutigam K, Christe L, Banz Y. Value of an Action Cam in Surgical Pathology. MEDICAL SCIENCE EDUCATOR 2022; 32:43-46. [PMID: 35154893 PMCID: PMC8814123 DOI: 10.1007/s40670-021-01480-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 06/14/2023]
Abstract
Grossing of surgical pathology specimens is a complex task, which may be challenging to master correctly. Despite the growing use of digital technology in other aspects of surgical pathology, little has been done so far to modernize the documentation of grossing. We used a portable video camera ("GoPro") to document different grossing procedures. The video material may be used for teaching purposes or might enhance the more commonplace macroscopic description by adding another dimension. Furthermore, video documentation may encourage the discussion of upcoming clinical questions or help rectify some possible initial impreciseness.
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Affiliation(s)
- Konstantin Bräutigam
- Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3008 Bern, Switzerland
| | - Lucine Christe
- Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3008 Bern, Switzerland
| | - Yara Banz
- Institute of Pathology, University of Bern, Murtenstrasse 31, CH-3008 Bern, Switzerland
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Abu-Rmaileh M, Osborn T, Gonzalez SR, Yuen JC. The Use of Live Streaming Technologies in Surgery: A Review of the Literature. Ann Plast Surg 2022; 88:122-127. [PMID: 34270473 DOI: 10.1097/sap.0000000000002909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Live streaming surgery is a developing communication platform in medicine. To maximize the technological advances that allow for the live streaming of surgery, it is crucial to have an understanding of the various video-capturing devices that are available and their pros and cons of implementation. Possible barriers to the widespread use of live streaming surgery include cost, concerns about patient safety and privacy, and limited understanding of the current available resources. In this article, we present the results of our literature review of techniques for live streaming of surgery as a means to inform readers and promote their implementation. METHODS We conducted a literature review of the literature to identify previous articles indexed in PubMed and Ovid. We used the following search terms: [Surgery AND Streaming], which generated 32 articles for initial review. References were reviewed within each document to find similar articles that were not captured by the initial search. The article selection criteria were peer-reviewed publications, case reports, and case series describing the use of live surgical streaming technologies. RESULTS Literature review showed enhanced surgeon interaction with viewers and improved anatomy scores with the widespread use of live streaming. Surgeons reported positive feedback and wished to engage in more sessions in the future. The largest barriers to implementation of streaming technology are video quality through the Internet and patient information protection. CONCLUSIONS Live streaming of surgery for educational purposes has not been widely accepted in surgical training programs to date. Streaming accessibility has advanced over the past 2 decades with the availability of handheld mobile devices. However, little has been done to allow for live streaming of surgery to trainees in a manner compliant with the Health Portability Insurance and Accountability Act.
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Affiliation(s)
| | - Tamara Osborn
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Santiago R Gonzalez
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA
| | - James C Yuen
- Division of Plastic Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
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Singas E, Quintero LD, Dhar S, Tsegaye A, Finuf K, Pekmezaris R, Weitzen MS, Mayo PH. Training Pulmonary Critical Care Medicine Fellows in Thoracentesis Using a Head-Mounted Video Camera. ATS Sch 2021; 2:632-641. [PMID: 35079742 PMCID: PMC8749010 DOI: 10.34197/ats-scholar.2021-0052in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/13/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Determination of competence to perform procedures during pulmonary critical care medicine fellowship training has traditionally been based on subjective faculty opinion and numerical requirements. OBJECTIVE To describe an objective means of assessing competence of fellows to perform thoracentesis using a head-mounted video camera with offline scoring of the thoracentesis performed on an actual patient. METHODS To test competence in performance of thoracentesis after a multimodality training program, a total of eight first-year fellows performed a thoracentesis on an actual patient while recording the procedure with a lightweight head-mounted video camera in 2017 and 2018. The recordings were scored offline by two faculty members using a 30-point checklist. The percentage agreement between scorers was measured, as was the opinion of the fellows and the scorers on the testing process. If a fellow failed completion of all checklist items, they were provided with further training and retested to assure competence. As part of their training, fellows reviewed the video record of their procedures. RESULTS Eight first-year fellows were tested, of whom seven successfully completed key checklist items as determined by the video scorers. One failing fellow passed after further training and testing. The percentage agreement between the scorers was high, and fellows indicated that the video device was useful for training. CONCLUSION This study supports the use of video-based testing for assessment of competence and for training in performance of thoracentesis by fellows.
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Affiliation(s)
- Effie Singas
- Division of Pulmonary, Critical Care and Sleep Medicine, and
| | | | - Sean Dhar
- Division of Pulmonary, Critical Care and Sleep Medicine, and
| | - Adey Tsegaye
- Division of Pulmonary, Critical Care and Sleep Medicine, and
| | - Kayla Finuf
- Division of Health Services Research, Center for Health Innovations and Outcomes Research, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra-Northwell, New Hyde Park, New York
| | - Renee Pekmezaris
- Division of Health Services Research, Center for Health Innovations and Outcomes Research, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra-Northwell, New Hyde Park, New York
| | - Maya S. Weitzen
- Division of Pulmonary, Critical Care and Sleep Medicine, and
| | - Paul H. Mayo
- Division of Pulmonary, Critical Care and Sleep Medicine, and
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13
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Bishop R, McCallister R, Bahroloomi S, Rietberg C, Kelley J, Wakam G, Waits S. How I Do It: Pilot Study of Video-Based Feedback as an Educational Tool for Medical Students' Presentations on Morning Rounds. JOURNAL OF SURGICAL EDUCATION 2021; 78:1425-1429. [PMID: 33558191 DOI: 10.1016/j.jsurg.2021.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/26/2021] [Accepted: 01/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Morning rounds are a bedrock learning opportunity during clinical rotations in medical school. Specific feedback is critical for students to improve presentation skills and build confidence, however, current feedback mechanisms are fragmented and nonstandard. We aimed to assess whether video-based coaching of morning rounds could improve student feedback and self-awareness without increasing anxiety during patient presentations. DESIGN Medical students during core clinical clerkships were filmed presenting on morning rounds during their surgery clerkship. A designated faculty coach reviewed the video prior to an in-person coaching session. Students reviewed the video with faculty and were coached on content, presentation style, and presence. A short survey assessed students' pre- and postcoaching confidence, skill, and the utility of the coaching session. SETTING University of Michigan Health System, Department of Surgery, Division of General Surgery, Ann Arbor, Michigan PARTICIPANTS: Eight medical student volunteers during their core clinical clerkships at University of Michigan Medical School during the surgery clerkship. RESULTS Comparison of pre- and post self-assessments showed that students underestimated their knowledge of basic and clinical science and overestimated their clinical assessment skills and ability to appropriately address the core components of a presentation. Most students (75%) did not think that the filming process altered their performance and only 25% of students felt increased anxiety due to filming. All students agreed that the feedback session was useful and helped them understand how to improve their oral presentations. CONCLUSION This pilot demonstrates the feasibility and value of video-based coaching as an educational tool for medical students on clerkships. A larger sample size is needed to further evaluate the effectiveness of video-based coaching in establishing baseline clinical abilities and identifying potential areas for improvement.
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Affiliation(s)
- Ruth Bishop
- University of Michigan Medical School, Ann Arbor, Michigan
| | | | | | | | - Jesse Kelley
- University of Michigan Medical School, Ann Arbor, Michigan
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14
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Luc JG, Antonoff MB, Vaporciyan AA, Yanagawa B. Surgeon teachers and millennial learners: Bridging the generation gap. J Thorac Cardiovasc Surg 2021; 162:334-341. [DOI: 10.1016/j.jtcvs.2020.03.177] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 03/08/2020] [Accepted: 03/22/2020] [Indexed: 12/20/2022]
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15
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Ramlogan RR, Chuan A, Mariano ER. Contemporary training methods in regional anaesthesia: fundamentals and innovations. Anaesthesia 2021; 76 Suppl 1:53-64. [PMID: 33426656 DOI: 10.1111/anae.15244] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 12/26/2022]
Abstract
Over the past two decades, regional anaesthesia and medical education as a whole have undergone a renaissance. Significant changes in our teaching methods and clinical practice have been influenced by improvements in our theoretical understanding as well as by technological innovations. More recently, there has been a focus on using foundational education principles to teach regional anaesthesia, and the evidence on how to best teach and assess trainees is growing. This narrative review will discuss fundamentals and innovations in regional anaesthesia training. We present the fundamentals in regional anaesthesia training, specifically the current state of simulation-based education, deliberate practice and curriculum design based on competency-based progression. Moving into the future, we present the latest innovations in web-based learning, emerging technologies for teaching and assessment and new developments in alternate reality learning systems.
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Affiliation(s)
- R R Ramlogan
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital Research Institute, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - A Chuan
- Department of Anaesthesia, Liverpool Hospital, South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - E R Mariano
- Department of Anesthesiology, Peri-operative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.,Anesthesiology and Peri-operative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
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16
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Koh W, Khoo D, Pan LTT, Lean LL, Loh MH, Chua TYV, Ti LK. Use of GoPro point-of-view camera in intubation simulation-A randomized controlled trial. PLoS One 2020; 15:e0243217. [PMID: 33259536 PMCID: PMC7707475 DOI: 10.1371/journal.pone.0243217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/17/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Teaching endotracheal intubation is uniquely challenging due to its technical, high-stakes, and highly time-sensitive nature. The GoPro is a small, lightweight, high-resolution action camera with a wide-angle field of view that can encompass both the airway as well as the procedurist’s hands and positioning technique when worn with a head mount. We aimed to evaluate its effectiveness in improving intubation teaching for novice learners in a simulated setting, via a two-arm, parallel group, randomized controlled superiority trial with 1:1 allocation ratio. Methods We recruited Year 4 medical students at the start of their compulsory 2-week Anesthesia posting. Participants underwent a standardized intubation curriculum and a formative assessment, then randomized to receive GoPro or non-GoPro led feedback. After a span of three months, participants were re-assessed in a summative assessment by blinded accessors. Participants were also surveyed on their learning experience for a qualitative thematic perspective. The primary outcomes were successful intubation and successful first-pass intubation. Results Seventy-one participants were recruited with no dropouts, and all were included in the analysis. 36 participants received GoPro led feedback, and 35 participants received non-GoPro led feedback. All participants successfully intubated the manikin. No statistically significant differences were found between the GoPro group and the non-GoPro group at summative assessment (85.3% vs 90.0%, p = 0.572). Almost all participants surveyed found the GoPro effective for their learning (98.5%). Common themes in the qualitative analysis were: the ability for an improved assessment, greater identification of small details that would otherwise be missed, and usefulness of the unique point-of-view footage in improving understanding. Conclusions The GoPro is a promising tool for simulation-based intubation teaching. There are considerations in its implementation to maximize the learning experience and yield from GoPro led feedback and training.
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Affiliation(s)
- Wenjun Koh
- Department of Anaesthesia, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Deborah Khoo
- Department of Anaesthesia, National University Health System, Singapore, Singapore
| | - Ling Te Terry Pan
- Department of Anaesthesia, National University Health System, Singapore, Singapore
| | - Lyn Li Lean
- Department of Anaesthesia, National University Health System, Singapore, Singapore
| | - May-Han Loh
- Department of Anaesthesia, National University Health System, Singapore, Singapore
| | - Tze Yuh Vanessa Chua
- Department of Anaesthesia, National University Health System, Singapore, Singapore
| | - Lian Kah Ti
- Department of Anaesthesia, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Anaesthesia, National University Health System, Singapore, Singapore
- * E-mail:
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17
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Navia A, Parada L, Urbina G, Vidal C, Morovic CG. Optimizing intraoral surgery video recording for residents' training during the COVID-19 pandemic: Comparison of 3 point of views using a GoPro. J Plast Reconstr Aesthet Surg 2020; 74:1101-1160. [PMID: 33199220 PMCID: PMC7648881 DOI: 10.1016/j.bjps.2020.10.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/20/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Alfonso Navia
- Section of Plastic and Reconstructive Surgery, Surgery Division, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago 8330024, Chile.
| | - Leonardo Parada
- Department of Plastic Surgery, Hospital Luis Calvo Mackenna, Santiago, Chile; Department of Plastic Surgery and Burns, Hospital del Trabajador de Santiago, Santiago, Chile
| | - Gloria Urbina
- Department of Plastic Surgery, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - Claudia Vidal
- Department of Plastic Surgery, Hospital Luis Calvo Mackenna, Santiago, Chile
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18
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MacDonald L, Ory J, Rendon RA, Bailly G, Skinner T, Cox A, Langille G, Bell D. Using GoPro to create an educational database of open urological procedures for residents. Can Urol Assoc J 2020; 15:207-209. [PMID: 33212004 DOI: 10.5489/cuaj.6768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Landan MacDonald
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Jesse Ory
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Ricardo A Rendon
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Gregory Bailly
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Thomas Skinner
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Ashley Cox
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Gavin Langille
- Department of Urology, Dalhousie University, Halifax, NS, Canada.,Horizon Health Network, Saint John, NB, Canada
| | - David Bell
- Department of Urology, Dalhousie University, Halifax, NS, Canada
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19
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Perkins SQ, Dabaja A, Atiemo H. Best Approaches to Evaluation and Feedback in Post-Graduate Medical Education. Curr Urol Rep 2020; 21:36. [PMID: 32789759 DOI: 10.1007/s11934-020-00991-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The objectives of this literature review are to appraise current approaches and assess new technologies that have been utilized for evaluation and feedback of residents, with focus on surgical trainees. RECENT FINDINGS In 1999, the Accreditation Council for Graduate Medical Education introduced the Milestone system as a tool for summative evaluation. The organization allows individual program autonomy on how evaluation and feedback are performed. In the past, questionnaire evaluations and informal verbal feedback were employed. However, with the advent of technology, they have taken a different shape in the form of crowdsourcing, mobile platforms, and simulation. Limited data is available on new methods but studies show promise citing low cost and positive impact on resident education. No one "best approach" exists for evaluation and feedback. However, it is apparent that a multimodal approach that is based on the ACGME Milestones can be effective and aid in guiding programs.
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Affiliation(s)
- Sara Q Perkins
- Henry Ford Health System, 2799 W Grand Blvd, K9, Detroit, MI, 48202, USA
| | - Ali Dabaja
- Henry Ford Health System, 2799 W Grand Blvd, K9, Detroit, MI, 48202, USA
| | - Humphrey Atiemo
- Henry Ford Health System, 2799 W Grand Blvd, K9, Detroit, MI, 48202, USA.
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20
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Hakimi AA, Hong EM, Prasad KR, Standiford L, Chang E, Wong BJF. A Novel Inexpensive Design for High Definition Intraoperative Videography. Surg Innov 2020; 27:699-701. [DOI: 10.1177/1553350620946315] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Amir A. Hakimi
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA, USA
| | - Ellen M. Hong
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA, USA
| | - Karthik R. Prasad
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA, USA
| | - Lauren Standiford
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA, USA
| | - Edward Chang
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA, USA
| | - Brian J. F. Wong
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, Samueli School of Engineering, University of California Irvine, Irvine, CA, USA
- Department of Otolaryngology, Head and Neck Surgery, University of California Irvine, Orange, CA, USA
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21
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Scully RE, Deal SB, Clark MJ, Yang K, Wnuk G, Smink DS, Fryer JP, Bohnen JD, Teitelbaum EN, Meyerson SL, Meier AH, Gauger PG, Reddy RM, Kendrick DE, Stern M, Hughes DT, Chipman JG, Patel JA, Alseidi A, George BC. Concordance Between Expert and Nonexpert Ratings of Condensed Video-Based Trainee Operative Performance Assessment. JOURNAL OF SURGICAL EDUCATION 2020; 77:627-634. [PMID: 32201143 DOI: 10.1016/j.jsurg.2019.12.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 12/18/2019] [Accepted: 12/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE We examined the impact of video editing and rater expertise in surgical resident evaluation on operative performance ratings of surgical trainees. DESIGN Randomized independent review of intraoperative video. SETTING Operative video was captured at a single, tertiary hospital in Boston, MA. PARTICIPANTS Six common general surgery procedures were video recorded of 6 attending-trainee dyads. Full-length and condensed versions (n = 12 videos) were then reviewed by 13 independent surgeon raters (5 evaluation experts, 8 nonexperts) using a crossed design. Trainee performance was rated using the Operative Performance Rating Scale, System for Improving and Measuring Procedural Learning (SIMPL) Performance scale, the Zwisch scale, and ten Cate scale. These ratings were then standardized before being compared using Bayesian mixed models with raters and videos treated as random effects. RESULTS Editing had no effect on the Operative Performance Rating Scale Overall Performance (-0.10, p = 0.30), SIMPL Performance (0.13, p = 0.71), Zwisch (-0.12, p = 0.27), and ten Cate scale (-0.13, p = 0.29). Additionally, rater expertise (evaluation expert vs. nonexpert) had no effect on the same scales (-0.16 (p = 0.32), 0.18 (p = 0.74), 0.25 (p = 0.81), and 0.25 (p = 0.17). CONCLUSIONS There is little difference in operative performance assessment scores when raters use condensed videos or when raters who are not experts in surgical resident evaluation are used. Future validation studies of operative performance assessment scales may be facilitated by using nonexpert surgeon raters viewing videos condensed using a standardized protocol.
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Affiliation(s)
- Rebecca E Scully
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Shanley B Deal
- Department of Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Michael J Clark
- Consulting for Statistics, Computing, and Analytics, University of Michigan, Ann Arbor, Michigan
| | - Katherine Yang
- Consulting for Statistics, Computing, and Analytics, University of Michigan, Ann Arbor, Michigan
| | - Greg Wnuk
- Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Douglas S Smink
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jonathan P Fryer
- Department of Surgery, Northwestern Memorial Hospital, Chicago, Illinois
| | - Jordan D Bohnen
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Ezra N Teitelbaum
- Department of Surgery, Northwestern Memorial Hospital, Chicago, Illinois
| | - Shari L Meyerson
- Department of Surgery, University of Kentucky Medical Center, Lexington, Kentucky
| | - Andreas H Meier
- Department of Surgery, SUNY Upstate University Hospital, Syracuse, New York
| | - Paul G Gauger
- Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Rishindra M Reddy
- Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Daniel E Kendrick
- University Hospitals Case Western Reserve, Cleveland Ohio; Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Michael Stern
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - David T Hughes
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Jeffrey G Chipman
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jitesh A Patel
- Department of Surgery, University of Kentucky Medical Center, Lexington, Kentucky
| | - Adnan Alseidi
- Department of Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Brian C George
- Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan
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22
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Silberthau KR, Chao TN, Newman JG. Innovating Surgical Education Using Video in the Otolaryngology Operating Room. JAMA Otolaryngol Head Neck Surg 2020; 146:321-322. [DOI: 10.1001/jamaoto.2019.4862] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Tiffany N. Chao
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Otolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia
| | - Jason G. Newman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Otolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia
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23
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Crannell WC, Brasel KJ. Dealing with the struggling learner. Surgery 2020; 167:523-527. [DOI: 10.1016/j.surg.2019.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/21/2019] [Accepted: 06/04/2019] [Indexed: 11/17/2022]
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24
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Lee SA, Lee JM, Suh KS, Hong SK, Cho JH, Yi NJ, Lee KW. Wearable recording video technology for surgical training in living donor liver transplantation. Ann Hepatobiliary Pancreat Surg 2020; 24:38-43. [PMID: 32181427 PMCID: PMC7061037 DOI: 10.14701/ahbps.2020.24.1.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 12/04/2022] Open
Abstract
Backgrounds/Aims As the development of surgical video recording technologies, educational videos have become widely utilized for trainee education. However, the current forms of surgical video are limited because they do not show all the roles of the participants. Aim of this study is to make optimal training material about living donor liver transplantation for residents and fellows using wearable recording system. Methods Three video clips about procedure of liver transplantation were made. A head mount was used to fix the camera on the surgeon or assistant's head. Anastomosis of vessels, bench operation and trocar insertion for laparoscopic donor hepatectomy were recorded. Each video clips were edited including indicators, subtitles, and narration. The edited videos were shown to 20 General Surgery trainees (18 residents, 2 fellows) and we received feedback. The results of the questionnaire were quantitatively analyzed to show how efficient and informative it is compared to existing educational materials. Results Sixteen of the 20 trainees (80%) responded that this video helped them improve their surgical skills. Eighteen trainees (90%) responded that they gained new knowledge through this video. Sixteen trainees (80%) responded that the action camera image material was more educational than existing text-based and video-based materials, with an average score of 8.5 and 6.5 (action camera materials vs. text-based materials, respectively). Conclusions A head-mounted action camera video recording system is a good model for making high-quality educational video modules and can be a useful teaching tool for living donor liver transplantation.
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Affiliation(s)
- Shin Ae Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong-Moo Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Suk-Kyun Hong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Hyung Cho
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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25
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Hakimi AA, Prasad KR, Hong EM, Standiford L, Chang E, Cobo R, Jang YJ, Wong BJF. Video Standards for Rhinoplasty Education: A Review and Recommended Guidelines. Facial Plast Surg Aesthet Med 2020; 22:219-224. [PMID: 32101478 DOI: 10.1089/fpsam.2020.0006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Importance: Intraoperative videography is widely used to record rhinoplasty procedures, yet little is known about the optimal surgical vantage points at critical procedural steps. Objective: To assess commonly used camera angles in public and proprietary intraoperative rhinoplasty videos and discuss approaches to obtaining these viewing angles. Design: Public and propriety rhinoplasty videos were reviewed and categorized based on procedure type, specific area(s) of focus, and camera angles utilized at a series of critical operative steps. The most commonly used camera angles were recorded and assessed based on surgical field visualization and the authors' personal recording experiences. Results: Of the 114 videos that met inclusion criteria, 49 were full-length open rhinoplasty procedures, 20 full-length endonasal rhinoplasty procedures, 17 tip techniques, 8 opening techniques, 7 fashioning grafts, 7 osteotomies, and 6 cartilage harvests. With respective to footage acquisition, the upward camera angle was most frequently used for recording, and endoscopic view was least frequently used. Conclusions and Relevance: These findings demonstrate that there is extensive variability in camera angles between surgical films. Moreover, many of these camera angles are insufficient due to obstruction by surgical staff, inability to visualize deep structures, and difficulty capturing the three-dimensional nasal framework. A guide indicating the best viewing angles for different aspects of the procedure would be useful to optimize educational videos.
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Affiliation(s)
- Amir A Hakimi
- Department of Otolaryngology, Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California, USA
| | - Karthik R Prasad
- Department of Otolaryngology, Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California, USA
| | - Ellen M Hong
- Department of Otolaryngology, Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California, USA
| | - Lauren Standiford
- Department of Otolaryngology, Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California, USA
| | - Edward Chang
- Department of Otolaryngology, Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California, USA
| | - Roxana Cobo
- Department of Otolaryngology, Centro Médico Imbanaco, Cali, Colombia
| | - Yong J Jang
- Department of Otolaryngology, Asan Medical Center, Seoul, Republic of Korea
| | - Brian J F Wong
- Department of Otolaryngology, Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California, USA.,Department of Biomedical Engineering, Samueli School of Engineering, University of California Irvine, Irvine, California, USA.,Department of Otolaryngology, Head and Neck Surgery, University of California Irvine, Orange, California, USA
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26
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Ganry L, Sigaux N, Ettinger KS, Salman SO, Fernandes RP. Modified GoPro Hero 6 and 7 for Intraoperative Surgical Recording-Transformation Into a Surgeon-Perspective Professional Quality Recording System. J Oral Maxillofac Surg 2019; 77:1703.e1-1703.e6. [PMID: 31009633 DOI: 10.1016/j.joms.2019.03.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/18/2019] [Indexed: 11/27/2022]
Abstract
Recent innovations in wearable action cameras with high-definition video recording enable surgeons to use cameras for their surgical procedures. In this study, the GoPro HERO 6 (and 7) Black edition camera was modified step by step to allow for a completely wireless surgeon-perspective recording with a battery life and memory capacity never previously obtained with such a high level of digital video quality. With this system, a surgeon can record for more than 14 hours 26 minutes in 1,080 pixels at 60 frames per second without breaking scrub and capture the operating surgeon's direct view of the field. By modifying the newest generation of devices, the authors successfully eliminated all shortcomings of the prior generation of GoPro cameras for surgical recording. The modified GoPro HERO6 camera produced professional recording quality for a total cost lower than US$850. This is critically important, because video-based surgical training will continue to be a primary area of development in the future and represents a novel and effective way for young generations of surgeons to attain technical excellence and knowledge in surgery.
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Affiliation(s)
- Laurent Ganry
- Head and Neck Oncologic Surgery and Microvascular Reconstruction Fellow, Division of Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
| | - Nicolas Sigaux
- Assisting Professor, Maxillofacial Surgery, Hospices Civils de Lyon, Centre Hospitalo-Universitaire Lyon-Sud, Université Claude Bernard Lyon I, Lyon; Plastic, Reconstructive and Esthetic Surgery, Hospices Civils de Lyon, Groupement Hospitalier Nord, Université Claude Bernard Lyon I, Lyon; Maxillofacial Surgery, Hospices Civils de Lyon, Université Claude Bernard Lyon I, Lyon, France
| | - Kyle S Ettinger
- Head and Neck Oncologic Surgery and Microvascular Reconstruction Fellow, Division of Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine-Jacksonville, Jacksonville, FL; Senior Associate Consultant, Mayo Clinic and Department of Surgery, Division of Oral and Maxillofacial Surgery, Mayo College of Medicine, Rochester, MN
| | - Salam O Salman
- Residency Program Director and Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Florida Health-Jacksonville, Jacksonville, FL
| | - Rui P Fernandes
- Chief, Division of Head and Neck Surgery; Program Director, Head and Neck Oncologic Surgery and Microvascular Fellowship; Associate Department Chair and Professor, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine-Jacksonville, Jacksonville, FL
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McKinley SK, Hashimoto DA, Mansur A, Cassidy D, Petrusa E, Mullen JT, Phitayakorn R, Gee DW. Feasibility and Perceived Usefulness of Using Head-Mounted Cameras for Resident Video Portfolios. J Surg Res 2019; 239:233-241. [PMID: 30856516 DOI: 10.1016/j.jss.2019.01.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/21/2018] [Accepted: 01/11/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND There is limited guidance on how to longitudinally administer simulation materials or to incorporate video recordings into assessment portfolios of simulated surgical skills. MATERIALS AND METHODS We launched a longitudinal weekly simulation curriculum for PGY1-PGY3 surgical residents based on the ACS/APDS Curriculum. Residents underwent monthly objective structured assessment of technical skills (OSATS) while wearing head-mounted cameras. Videos of OSATS performance accrued into individual online video portfolios. Residents were surveyed about their attitudes toward video recording. RESULTS Twenty-seven general surgical residents participated, completing 161 OSATS encompassing 11 distinct skills and generating 258 videos of simulated skills performance. The overall survey response rate was 88%. Residents viewed the curriculum favorably overall, and 36.4% of residents accessed their videos. Of those who did not watch their videos, 78.6% cited not having enough time, whereas 28.6% did not think the videos would be useful. Over 95% of surveyed residents expressed interest in having a video library of attending-performed procedures, 59.1% were interested in having their own operations recorded, and 45.5% were interested in video-based coaching. CONCLUSIONS Residents viewed longitudinal administration of the ACS/APDS Curriculum positively. Although video recording in simulation is feasible, resident interest may be higher for intraoperative recordings than for simulated skills.
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Affiliation(s)
- Sophia K McKinley
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Daniel A Hashimoto
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Arian Mansur
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Douglas Cassidy
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - John T Mullen
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Denise W Gee
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
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Bjorklund KA, Sommer N, Neumeister MW, Kasten SJ. Establishing Validity Evidence for an Operative Performance Rating System for Plastic Surgery Residents. JOURNAL OF SURGICAL EDUCATION 2019; 76:529-539. [PMID: 30253984 DOI: 10.1016/j.jsurg.2018.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 08/16/2018] [Accepted: 08/18/2018] [Indexed: 05/22/2023]
Abstract
OBJECTIVE The aim of this study was to describe an operative performance rating system for plastic surgery residents and provide validity evidence for the instrument. METHODS Three plastic surgery residents (PGY levels 1, 5, and 6) from Southern Illinois University School of Medicine (SIUSOM) performed a carpal tunnel release with audio video recording. The 3 videos were reviewed by 8 expert hand surgeons and 3 SIUSOM faculty using the operative performance rating system instrument to assess resident operative performance. Validity evidence including content, internal structure, and relationship to other variables was collected. RESULTS Inter-rater reliability was consistently fair to moderate (weighted Cohen's Kappa 0.44-0.84 for experts, 0.24-0.55 for SIUSOM raters), and all assessment items were highly correlated (Cronbach's alpha of 0.9867). Local SIUSOM faculty routinely demonstrated higher overall scores for PGY 1 and PGY 6 residents compared to expert raters. CONCLUSIONS Although limited by small numbers, this pilot study suggests that potential bias based upon PGY year, identity, and performance history may exist and independent assessment by unbiased raters or comparison to national operative norms may be valuable. Our study provides baseline validity evidence for a resident operative performance assessment tool that can be integrated into practice in plastic surgery training programs.
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Affiliation(s)
- Kim A Bjorklund
- Section of Plastic and Reconstructive Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
| | - Nicole Sommer
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Michael W Neumeister
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Steven J Kasten
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
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29
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Wojcik BM, Lee JM, Peponis T, Amari N, Mendoza AE, Rosenthal MG, Saillant NN, Fagenholz PJ, King DR, Phitayakorn R, Velmahos G, Kaafarani HM. Do Not Blame the Resident: the Impact of Surgeon and Surgical Trainee Experience on the Occurrence of Intraoperative Adverse Events (iAEs) in Abdominal Surgery. JOURNAL OF SURGICAL EDUCATION 2018; 75:e156-e167. [PMID: 30195664 DOI: 10.1016/j.jsurg.2018.07.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/10/2018] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Intraoperative adverse events (iAEs) are defined as inadvertent injuries that occur during an operation and are associated with increased mortality, morbidity, and health care costs. We sought to study the impact of attending surgeon experience as well as resident training level on the occurrence of iAEs. DESIGN The institutional American College of Surgeons-National Surgical Quality Improvement Program and administrative databases for abdominal surgeries were linked and screened for iAEs using the International Classification of Diseases, Ninth Revision, Clinical Modification-based Patient Safety Indicator "accidental puncture/laceration." Each flagged record was systematically reviewed to confirm iAE occurrence and determine the number of years of independent practice of the attending surgeon and the postgraduate year (PGY) of the assisting resident at the time of the operation. The attending surgeon experience was divided into quartiles (<6 years, 6-13 years, 13-20 years, >20 years). The resident experience level was defined as Junior (PGY-1 to PGY-3) or Senior (PGY-4 or PGY-5). Univariate/bivariate then multivariable logistic regression analyses adjusting for patient demographics, comorbidities, and operation type and/or complexity (using RVUs as a proxy) were performed to assess the independent impact of resident and attending surgeon experience on the occurrence of iAEs. SETTING A large tertiary care teaching hospital. PARTICIPANTS Patients included in the 2007-2012 ACS-NSQIP that had an abdominal surgery performed by both an attending surgeon and a resident. RESULTS A total of 7685 operations were included and iAEs were detected in 159 of them (2.1%). Junior residents participated in 1680 cases (21.9%), while senior residents were involved in 6005 (78.1%). The iAE rates for attending surgeons with <6, 6-13, 13-20, and >20 years of experience were 2.7%, 1.7%, 2.4%, and 1.4%, respectively. In multivariable analyses, the risk of occurrence of an iAE was significantly decreased for surgeons with >20 years of experience compared to those with <6 years of experience (odds ratio=0.52, 95% confidence interval 0.32-0.86, p = 0.011). On bivariate analyses, iAEs occurred in 1.2% of junior resident cases, while senior residents had an iAE rate of 2.3%. However, after risk adjustment on multivariable analyses, the resident experience level did not significantly impact the rate of iAEs. CONCLUSIONS The surgeon's level of experience, but not the resident's, is associated with the occurrence of iAEs in abdominal surgery. Efforts to improve patient safety in surgery should explore the value of pairing junior surgeons with the more experienced ones thru formalized coaching programs, rather than focus on curbing resident operative autonomy.
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Affiliation(s)
- Brandon M Wojcik
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Jae Moo Lee
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Thomas Peponis
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Noor Amari
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - April E Mendoza
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Martin G Rosenthal
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Noelle N Saillant
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Peter J Fagenholz
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - David R King
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Roy Phitayakorn
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - George Velmahos
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
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30
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Hakimi AA, Hu AC, Pham TT, Wong BJF. High-definition point-of-view intraoperative recording using a smartphone: A hands-free approach. Laryngoscope 2018; 129:578-581. [PMID: 30329154 DOI: 10.1002/lary.27307] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/26/2018] [Accepted: 05/03/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Intraoperative recording devices are being increasingly used to provide video for contemporary surgical training. The objective of this study was to evaluate the use of a smartphone as a low-cost alternative to obtain high-resolution video from the surgeon's perspective. STUDY DESIGN A study evaluating the feasibility of using a head-mounted smartphone with a telephoto lens for point-of-view surgical videography. METHODS Video recordings of a rhinoplasty procedure were taken using a head-mounted smartphone and two handheld cameras, a Canon Powershot SD1400 IS and a Sony HandyCam HDR-CX160. Video clips were shown to 16 blinded otolaryngology residents (n = 10) and attending physicians (n = 6) for individual video evaluation using a Likert scale (1 being poor quality, 5 being excellent quality). In addition, the study participants were asked to select which video clip they preferred when presented to them side by side. RESULTS The iPhone 7 was given the highest overall mean video quality rating of 3.9 ± 0.57 and was preferred over the two handheld cameras by nearly all surveyed surgeons. The Canon Powershot SD1400 IS was given a mean rating of 3.3 ± 1.0 and preferred over the SonyHandyCam HDR-CX160 by all surgeons. The Sony HandyCam HDR-CX160 was given a mean rating of 1.5 ± 0.13. CONCLUSIONS A head-mounted smartphone equipped with a telephoto lens provides a novel method to intraoperative surgical recording. The design is simple, low cost, and allows the surgeon to capture fine anatomical detail from the desirable point-of-view perspective. LEVEL OF EVIDENCE NA Laryngoscope, 129:578-581, 2019.
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Affiliation(s)
- Amir A Hakimi
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Allison C Hu
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California.,Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, California
| | - Tiffany T Pham
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California.,Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, California
| | - Brian J F Wong
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California.,Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, California.,Department of Biomedical Engineering, Samueli School of Engineering, University of California Irvine, Irvine, California, U.S.A
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