Remote training in laparoscopy: a randomized trial comparing home-based self-regulated training to centralized instructor-regulated training

Sloth, Sigurd Beier; Jensen, Rune Dall; Seyer‐Hansen, Mikkel; Christensen, Mette Krogh; Win, Gunter De

doi:10.1007/s00464-021-08429-7

Cited by 14 publications

(12 citation statements)

References 60 publications

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“…Several additional small studies assessing remote training for surgical skills have also been reported. These generally involve the teaching of basic surgical skills using box trainers such as peg transfer, knot tying, and suturing techniques under laparoscopy (25,26). Recently a course utilizing remote guidance of actual endovascular surgery using augmented reality (AR), has also been published (27).…”

Section: Discussionmentioning

confidence: 99%

Remote Training of Functional Endoscopic Sinus Surgery With Advanced Manufactured 3D Sinus Models and a Telemedicine System

et al. 2021

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Objective: Traditionally, cadaveric courses have been an important tool in surgical education for Functional Endoscopic Sinus Surgery (FESS). The recent COVID-19 pandemic, however, has had a significant global impact on such courses due to its travel restrictions, social distancing regulations, and infection risk. Here, we report the world-first remote (Functional Endoscopic Sinus Surgery) FESS training course between Japan and Australia, utilizing novel 3D-printed sinus models. We examined the feasibility and educational effect of the course conducted entirely remotely with encrypted telemedicine software.Methods: Three otolaryngologists in Hokkaido, Japan, were trained to perform frontal sinus dissections on novel 3D sinus models of increasing difficulty, by two rhinologists located in Adelaide, South Australia. The advanced manufactured sinus models were 3D printed from the Computed tomography (CT) scans of patients with chronic rhinosinusitis. Using Zoom and the Quintree telemedicine platform, the surgeons in Adelaide first lectured the Japanese surgeons on the Building Block Concept for a three Dimensional understanding of the frontal recess. They in real time directly supervised the surgeons as they planned and then performed the frontal sinus dissections. The Japanese surgeons were asked to complete a questionnaire pertaining to their experience and the time taken to perform the frontal dissection was recorded. The course was streamed to over 200 otolaryngologists worldwide.Results: All dissectors completed five frontal sinusotomies. The time to identify the frontal sinus drainage pathway (FSDP) significantly reduced from 1,292 ± 672 to 321 ± 267 s (p = 0.02), despite an increase in the difficulty of the frontal recess anatomy. Image analysis revealed the volume of FSDP was improved (2.36 ± 0.00 to 9.70 ± 1.49 ml, p = 0.014). Questionnaires showed the course's general benefit was 95.47 ± 5.13 in dissectors and 89.24 ± 15.75 in audiences.Conclusion: The combination of telemedicine software, web-conferencing technology, standardized 3D sinus models, and expert supervision, provides excellent training outcomes for surgeons in circumstances when classical surgical workshops cannot be realized.

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Section: Discussionmentioning

confidence: 99%

Remote Training of Functional Endoscopic Sinus Surgery With Advanced Manufactured 3D Sinus Models and a Telemedicine System

et al. 2021

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“…In an online interactive basic surgical skills course, medical students were able to demonstrate proficiency in knot tying and simple suturing and were satisfied with this learning method 9. Additionally, a randomized controlled trial was conducted that evaluated the difference between centralized, instructor-regulated training and “home-based, self-regulated training” in laparoscopy 19. The authors reported that surgical trainees who participated in “home-based, self-regulated training” had a 9% higher passing rate than those in the instructor-led group, suggesting that individual learning is as effective as didactic and in-person instruction in laparoscopy 19.…”

Section: Discussionmentioning

confidence: 99%

“…9 Additionally, a randomized controlled trial was conducted that evaluated the difference between centralized, instructor-regulated training and "home-based, self-regulated training" in laparoscopy. 19 The authors reported that surgical trainees who participated in "home-based, self-regulated training" had a 9% higher passing rate than those in the instructor-led group, suggesting that individual learning is as effective as didactic and inperson instruction in laparoscopy. 19 However, a survey of medical and dental students revealed that more students (73.5%) were satisfied with traditional anatomy education than online lectures (56%).…”

Section: Discussionmentioning

confidence: 99%

“…19 The authors reported that surgical trainees who participated in "home-based, self-regulated training" had a 9% higher passing rate than those in the instructor-led group, suggesting that individual learning is as effective as didactic and inperson instruction in laparoscopy. 19 However, a survey of medical and dental students revealed that more students (73.5%) were satisfied with traditional anatomy education than online lectures (56%). 20 In addition, online learning was shown to negatively affect exam performance.…”

Section: Discussionmentioning

confidence: 99%

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Virtual orthopaedic surgery away rotation benefits both the program and applicant: a survey of participants

White

Montgomery

Romer

et al. 2022

Current Orthopaedic Practice

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Background:The COVID-19 pandemic has forced many medical education institutions to switch from in-person to online learning environments. There is an existing gap in knowledge about the effectiveness of virtual learning for medical students. Objective:The purpose of the study was to determine if virtual orthopaedic surgery away rotations (VOSAR) benefit medical students and programs. Methods:Virtual rotations were created at two large residency programs for fourth-year medical students. From October 12, 2020 through December 28, 2020, satisfaction and quality were assessed using a 22-question survey, residency interview, rank, and match data. Forty-two fourth-year medical students participated, 38 of whom responded to the survey. Results:Most students stated course objectives were clear and consistent with coursework. Most were pleased with the variety of cases and presentations and were able to meaningfully interact with faculty and residents. Most stated they would participate again and suggest the rotation to others. Twenty-five of 42 participants were ranked by at least one program; 39 were accepted into residency positions, 21 of which were in orthopaedic surgery. Conclusions:The results indicate that the VOSAR benefits students and programs. Based on the success of the VOSAR, both programs continued to offer the curriculum for 2021.

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“…Informants were regularly invited on a voluntary basis among trainees participating in a six-week simulationbased laparoscopic skills training program. The training was situated and facilitated in two ways, i.e., by centralised or remote training, based on a previously published randomised comparative study investigating training patterns and performance outcomes between the two training modalities [24]. The training was structured as PBT, and training equipment was the same between groups.…”

Section: Context and Samplementioning

confidence: 99%

Ticket to perform: an explorative study of trainees’ engagement in and transfer of surgical training

et al. 2023

Self Cite

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Background Research suggests that simulation-based surgical skills training translates into improved operating room performance. Previous studies have predominantly focused on training methods and design and subsequent assessable performances and outcomes in the operating room, which only covers some aspects of training engagement and transfer of training. The purpose of this qualitative study was to contribute to the existing body of literature by exploring characteristics of first-year trainees’ engagement in and perceptions of transfer of surgical skills training. Methods We conducted an explorative study based on individual interviews with first-year trainees in General Surgery, Urology, and Gynaecology and Obstetrics who participated in a laparoscopic skills training program. Informants were interviewed during and two months after the training program. A thematic cross-case analysis was conducted using systematic text condensation. Results We interviewed 12 informants, which produced 24 transcripts for analysis. We identified four main themes: (1) sportification of training, (2) modes of orientation, (3) transferrable skills, and (4) transfer opportunities. Informants described their surgical training using sports analogies of competition, timing, and step-by-step approaches. Visual orientations, kinaesthetic experiences, and elicited dialogues characterised training processes and engagement. These characteristics were identified in both the simulated and the clinical environment. Experiences of specific skills transfer included ambidexterity, coordination, instrument handling, and visuospatial ability. General transfer experiences were salient in informants’ altered training approaches. Informants considered the simulation-based training an entry ticket to perform in the operating room and mentioned supervisor-trainee relationships and opportunities in the workplace as critical conditions of transfer. Conclusions Our findings elucidate characteristics of surgical training engagement that can be interpreted as self-regulated learning processes that transcend surgical training environments. Despite appreciating the immediate skills improvements resulting from training, trainees’ narratives reflected a struggle to transfer their training to the clinical setting. Tensions existed between perceptions of transferable skills and experiences of transfer within the clinical work environments. These results resonate with research emphasising the importance of the work environment in the transfer process. Our findings provide insights that may inform the development of training programs that support self-regulated learning and transfer of training from the simulated to the clinical environment.

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Remote training in laparoscopy: a randomized trial comparing home-based self-regulated training to centralized instructor-regulated training

Cited by 14 publications

References 60 publications

Remote Training of Functional Endoscopic Sinus Surgery With Advanced Manufactured 3D Sinus Models and a Telemedicine System

Remote Training of Functional Endoscopic Sinus Surgery With Advanced Manufactured 3D Sinus Models and a Telemedicine System

Virtual orthopaedic surgery away rotation benefits both the program and applicant: a survey of participants

Ticket to perform: an explorative study of trainees’ engagement in and transfer of surgical training

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