Educational Impact of Automated Feedback Systems in Surgical Training: A Systematic Review With Quantitative...

Area of Science:

• Medical Education
• Surgical Training
• Health Informatics

Background:

• Technical surgical skill acquisition is crucial for patient safety.
• Traditional training methods may lack objective, immediate feedback.
• Automated feedback systems (AFS) offer potential for standardized skill development.

Purpose of the Study:

• To systematically evaluate the impact of AFS on technical surgical skill acquisition.
• To assess AFS effectiveness in simulation-based surgical training environments.

Main Methods:

• PRISMA-guided systematic review of 14 studies (814 trainees) published May 2013-December 2024.
• Included studies compared AFS with no feedback or assessed AFS impact on technical skill in simulation settings.
• Risk of bias and certainty of evidence were assessed using ROB-2, ROBINS-I, and GRADE.

Main Results:

• All studies reported technical skill improvement with AFS, with 9 showing significant gains (mean 38.1% improvement).
• Pooled analysis indicated a moderate-to-large benefit (Hedges' g = 0.81).
• AFS improved learner satisfaction (60%), reduced path length (41%), increased speed (9.4%), and reduced applied force (11.8%).

Conclusions:

• AFS are associated with moderate-to-large improvements in technical surgical performance, especially for foundational tasks.
• Evidence supports AFS as a valuable adjunct in early surgical training, primarily within simulation settings.
• Integration with expert oversight is essential for maximizing benefits and ensuring transferability to clinical practice.