Can surgical skills be taught using technological advances online? A comparative study of online and face-to-face surgical skills training

INTRODUCTION

Online teaching has rapidly emerged as a viable alternative to traditional face-to-face education. How to teach surgical skills in the online environment, however, has not yet been fully established nor evaluated.

METHODS

An international 1-day online surgical skills course consisting of lectures, pre-recorded virtual workshops, live demonstrations and along with surgical skills teaching in breakout rooms was organised. Based on existing learning theories, new methods were developed to deliver skills teaching online. Simultaneously, traditional in-person surgical skills teaching was also conducted and used as a benchmark. Skills development was assessed by trained demonstrators and self-reported competency scores were compared between the online and face-to-face event.

RESULTS

553 delegates from 20 different countries attended the online course. Of these, 64 were trained in breakout rooms with a 1:5 demonstrator-to-delegate ratio whilst the remaining 489 delegates participated in didactic skills development sessions. In a separate face-to-face course, 20 delegates were trained with traditional methods. Demonstrators rated the competency of delegates for suturing, tendon repair and vascular anastomosis. There was no significant difference in the competency ratings of delegates receiving online teaching or face-to-face teaching (p = 0.253, p = 0.084, p = 1.00, respectively). The development of the same skills to "articulation" were not different between formats (p = 0.841, p = 0.792, p = 1.00, respectively). Post course self-rated competency scores improved for all technical skills (p < 0.001). Small group sessions, both online and face-to-face, received higher satisfaction ratings compared to large group sessions in terms of clarity of instructions, answers to questions and demonstrator feedback. Overall feedback on teaching quality, however, was equivalent across both groups.

DISCUSSION

Online teaching of surgical skills for early training years is an appropriate alternative to face-to-face teaching.

An evaluation of operative self-assessment by UK postgraduate trainees

BACKGROUND

Surgeons in training undertake procedure-based assessment (PBA) with their trainers. Time pressures limit when this occurs. Self-assessment would provide additional opportunities but requires evaluation of your own skills and knowledge.

AIM

To investigate the validity of a self-assessment PBA in the operating theatre and evaluate learning needs and change in practice identified.

METHODS

In a prospective study, postgraduate UK trainees performed a self-assessment PBA after formally reflecting on appendicectomy surgery. Later, they performed their usual external assessment PBA on the same case and outcomes were compared. Learning outcomes were analysed independently by two trainers.

RESULTS

There were 25 trainees (14 males), of age 29 years (25-33). They had performed a median of five previous appendicectomies (2-21) after a median three years of speciality training (range 1-4). There were no significant differences in global summary scores, trainee satisfaction or learning outcomes between external and self-assessment PBAs. Construct validity of the self-assessment PBA was demonstrated. The self-assessment PBA was more likely to identify non-technical skills.

CONCLUSION

Our results suggest self-assessment PBA is valid for formative assessment. It identified a wide range of learning outcomes. Self-assessment PBA would help trainees maximise every learning opportunity and practice self-assessment skills.