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A Multicenter, Randomized Controlled Trial to Assess Video-Based Surgical Coaching in Gynecology
Brenna E Swift1, Charlotte Axelrod2, Anouk Benseler2
1University of Toronto Department of Obstetrics and Gynecology, (Drs. Swift, Axelrod, Vicus, Laframboise, Walker, Sobel, and Tannenbaum), Toronto, Ontario; Sunnybrook Health Sciences Center, Division of Gynecologic Oncology, (Drs. Swift and Vicus) Toronto, Ontario.
Study Objective:
To evaluate the effect of video-based coaching on technical skill development in surgical education.
Design:
Randomized controlled trial with video-based coaching (intervention group) in addition to standard surgical curriculum or the standard surgical curriculum alone (control group).
Setting:
Laparoscopic vaginal vault closure in the operating room at 3 academic hospitals.
Participants:
Senior Obstetrics and Gynecology residents (year 3-5) on their chief resident or gynecologic oncology rotation.
Interventions:
All residents were recorded performing laparoscopic closure of the vaginal cuff prior to randomization. Surgical coaching sessions followed the Wisconsin Surgical Coaching Framework over 30 minutes on Zoom with one surgical coach. All residents were recorded subsequently performing the same surgical technical skill. Blinded, expert surgeons performed the video assessment using the OSATS, GOALS, and global rating scale. The mean change in operative time and the mean change in video-assessment score between the 2 video-recorded attempts were compared between groups. Qualitative semi-structured interviews were conducted to understand the residents' perspective on video-based surgical coaching.
Measurements And Main Results:
Twenty residents participated with 10 in the coaching and 10 in the control group. Mean operative time to complete the suturing task was reduced by 32.8% (SD = 21.3%) in the coached group vs 7.2% (SD = 25.1%) in the control group (p = .025). There was no significant change in surgical assessment scores within the coached or control group. Residents identified the core components of a surgical coaching program to include: (1) the resident: focused skill development, (2) the coach: focused on feedback, (3) and the coaching program: a structured activity. Residents envisioned monthly coaching with the opportunity for deliberate practice, the importance of a positive relationship between the coach and coachee, and the importance of faculty development in surgical coaching.
Conclusion:
Video-based surgical coaching is an effective tool to enhance technical skill development in surgical education.
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