Virtual Interactive Surgical Skills Classroom: A Parallel-group, Non-inferiority, Adjudicator-blinded, Randomised Controlled Trial (VIRTUAL)

Nathan, Arjun; Fricker, Monty; Georgi, Maria; Patel, Sonam; Hang, Man Kien; Asif, Aqua; Sinha, Amil; Mullins, W. W.; Shea, Jessie; Hanna, Nancy; Monks, Massimo; Peprah, David; Sharma, Akash; Ninkovic-Hall, George; Lamb, Benjamin; Kelly, John D.; Sridhar, Ashwin; Collins, Justin

doi:10.1016/j.jsurg.2021.11.004

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…Second, students may lack a home environment appropriate to attend a sitting or examination or may have obstacles to access adequate online facilities [ 29 ]. Further, the role of teacher–student interactions in the context of media-based education of practical surgical skills is under controversial discussion [ 30 – 32 ].…”

Section: Discussionmentioning

confidence: 99%

Struggle in the bubble - a prospective study on the effect of remote learning and distance education on confidence in practical surgical skills acquired during COVID-19

et al. 2023

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Background The coronavirus disease (COVID-19) has significantly changed healthcare systems and medical education. Universities were required to develop innovative curricula based on remote and distance education to continue medical education. This prospective questionnaire-based study aimed to investigate the impact of COVID-19-associated remote learning on the surgical training of medical students. Methods A 16-item questionnaire-based survey was distributed to medical students at the University Hospital of Münster before and after a surgical skills laboratory (SSL). Two cohorts were included: summer semester 2021 (COV-19), with rigorous social-distancing restrictions requiered SSL to be remotely, and winter semester 2021 (postCOV-19), in which the SSL was provided as a face-to-face, hands-on course. Results Both, cohorts showed a significant improvement in self-assessment of pre- and post-course confidence. While no significant difference in the average gain in self-confidence for sterile working was observed between the two cohorts, improvement in self-confidence was significantly higher in the COV-19 cohort regarding skin suturing and knot tying (p < 0.0001). However the average improvement regarding history and physical was significantly higher in the postCOV-19 cohort (p < 0.0001). In subgroup analysis, gender-associated differences varied in the two cohorts and were not related to specific subtasks, while age-stratified analysis revealed superior results for younger students. Conclusion The results of our study underline the usability, feasibility, and adequacy of remote learning for the surgical training of medical students. The on-site distance education version, presented in the study, allows the continuing of hands-on experience in a safe environment in compliance with governmental social-distancing restrictions.

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Section: Discussionmentioning

confidence: 99%

Struggle in the bubble - a prospective study on the effect of remote learning and distance education on confidence in practical surgical skills acquired during COVID-19

et al. 2023

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“…These limitations have been further amplified during the pandemic [ 3 ]. There is evidence that the virtual classroom can improve access and efficiencies by increasing the number of delegates that can be trained in this educational setting, compared to face-to-face teaching [ 16 ]. Supplementing robotic skills training with virtual classroom teaching is a potential way to improve training and reduce the steep learning curve of robotic surgery to reach proficiency in robotic technical skills, in a scalable way that addresses current training needs.…”

Section: Discussionmentioning

confidence: 99%

“…Virtual classroom training (VCT) is a novel training modality that enables the combination of computer-based learning, with concurrent expert instruction and live interactive feedback via synchronous video communication [ 16 ]. It has the potential to offer increased effectiveness and accessibility to robot-assisted surgical training programs, reduce costs, and facilitate large-scale teaching.…”

Section: Introductionmentioning

confidence: 99%

Virtual classroom proficiency-based progression for robotic surgery training (VROBOT): a randomised, prospective, cross-over, effectiveness study

et al. 2022

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Robotic surgery training has lacked evidence-based standardisation. We aimed to determine the effectiveness of adjunctive interactive virtual classroom training (VCT) in concordance with the self-directed Fundamentals of Robotic Surgery (FRS) curriculum. The virtual classroom is comprised of a studio with multiple audio–visual inputs to which participants can connect remotely via the BARCO weConnect platform. Eleven novice surgical trainees were randomly allocated to two training groups (A and B). In week 1, both groups completed a robotic skills induction. In week 2, Group A received training with the FRS curriculum and adjunctive VCT; Group B only received access to the FRS curriculum. In week 3, the groups received the alternate intervention. The primary outcome was measured using the validated robotic-objective structured assessment of technical skills (R-OSAT) at the end of week 2 (time-point 1) and 3 (time-point 2). All participants completed the training curriculum and were included in the final analyses. At time-point 1, Group A achieved a statistically significant greater mean proficiency score compared to Group B (44.80 vs 35.33 points, p = 0.006). At time-point 2, there was no significant difference in mean proficiency score in Group A from time-point 1. In contrast, Group B, who received further adjunctive VCT showed significant improvement in mean proficiency by 9.67 points from time-point 1 (95% CI 5.18–14.15, p = 0.003). VCT is an effective, accessible training adjunct to self-directed robotic skills training. With the steep learning curve in robotic surgery training, VCT offers interactive, expert-led learning and can increase training effectiveness and accessibility.

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“…This was conducted through audio and visual recording of presentation, mini-poll and open discussion using the UCL Virtual Software Platform (University College London, London) [ 47 ]. Given the study was run during the COVID-19 pandemic participants were asked to rate the impact of the pandemic on their current training using a Likert scale of 0 (No Disruption) to 5 (Significant Disruption) as an indication of general disruption to current surgical training which could influence opinion on surgical training as a whole.…”

Section: Methodsmentioning

confidence: 99%

Utilising an accelerated Delphi process to develop consensus on the requirement and components of a pre-procedural core robotic surgery curriculum

et al. 2023

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Robot-assisted surgery (RAS) continues to grow globally. Despite this, in the UK and Ireland, it is estimated that over 70% of surgical trainees across all specialities have no access to robot-assisted surgical training (RAST). This study aimed to provide educational stakeholders guidance on a pre-procedural core robotic surgery curriculum (PPCRC) from the perspective of the end user; the surgical trainee. The study was conducted in four Phases: P1: a steering group was formed to review current literature and summarise the evidence, P2: Pan-Specialty Trainee Panel Virtual Classroom Discussion, P3: Accelerated Delphi Process and P4: Formulation of Recommendations. Forty-three surgeons in training representing all surgical specialties and training levels contributed to the three round Delphi process. Additions to the second- and third-round surveys were formulated based on the answers and comments from previous rounds. Consensus opinion was defined as ≥ 80% agreement. There was 100% response from all three rounds. The resulting formulated guidance showed good internal consistency, with a Cronbach alpha of > 0.8. There was 97.7% agreement that a standardised PPCRC would be advantageous to training and that, independent of speciality, there should be a common approach (95.5% agreement). Consensus was reached in multiple areas: 1. Experience and Exposure, 2. Access and context, 3. Curriculum Components, 4 Target Groups and Delivery, 5. Objective Metrics, Benchmarking and Assessment. Using the Delphi methodology, we achieved multispecialty consensus among trainees to develop and reach content validation for the requirements and components of a PPCRC. This guidance will benefit from further validation following implementation.

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Virtual Interactive Surgical Skills Classroom: A Parallel-group, Non-inferiority, Adjudicator-blinded, Randomised Controlled Trial (VIRTUAL)

Cited by 9 publications

References 29 publications

Struggle in the bubble - a prospective study on the effect of remote learning and distance education on confidence in practical surgical skills acquired during COVID-19

Struggle in the bubble - a prospective study on the effect of remote learning and distance education on confidence in practical surgical skills acquired during COVID-19

Virtual classroom proficiency-based progression for robotic surgery training (VROBOT): a randomised, prospective, cross-over, effectiveness study

Utilising an accelerated Delphi process to develop consensus on the requirement and components of a pre-procedural core robotic surgery curriculum

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