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Video-based coaching in surgical education: a systematic review and meta-analysis

  • Knut Magne AugestadEmail author
  • Khayam Butt
  • Dejan Ignjatovic
  • Deborah S. Keller
  • Ravi Kiran
Review Article

Abstract

Background

In the era of competency-based surgical education, VBC has gained increased attention and may enhance the efficacy of surgical education. The objective of this systematic review was to summarize the existing evidence of video-based coaching (VBC) and compare VBC to traditional master-apprentice-based surgical education.

Methods

We performed a systematic review and meta-analysis of randomized controlled trials (RCT) assessing VBC according to the PRISMA and Cochrane guidelines. The MEDLINE, EMBASE, and COCHRANE and Researchgate databases were searched for eligible manuscripts. Standard mean difference (SMD) of performance scoring scales was used to assess the effect of VBC versus traditional training without VBC (control).

Results

Of 627 studies identified, 24 RCTs were eligible and evaluated. The studies included 778 surgical trainees (n = 386 VBC vs. n = 392 control). 13 performance scoring scales were used to assess technical competence; OSATS-GRS was the most common (n = 15). VBC was provided preoperative (n = 11), intraoperative (n = 1), postoperative (n = 10), and perioperative (n = 2). The majority of studies were unstructured, where identified coaching frameworks were PRACTICE (n = 1), GROW (n = 2) and Wisconsin Coaching Framework (n = 1). There was an effect on performance scoring scales in favor of VBC coaching (SMD 0.87, p < 0.001). In subgroup analyses, the residents had a larger relative effect (SMD 1.13; 0.61–1.65, p < 0.001) of VBC compared to medical students (SMD 0.43, 0.06–0.81, p < 0.001). The greatest source of potential bias was absence of blinding of the participants and personnel (n = 20).

Conclusion

Video-based coaching increases technical performance of medical students and surgical residents. There exist significant study and intervention heterogeneity that warrants further exploration, showing the need to structure and standardize video-based coaching tools.

Keywords

Surgical training Surgical education Video-based coaching (VBC) OSATS GOALS 

Abbreviations

MAM

Master-apprentice model

VBC

VBC coaching

SMD

Standard mean difference

Notes

Acknowledgements

We thank Dr Alameddine for providing additional unpublished data to the survey.

Author contributions

KMA had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: KMA, KB, DI, DSK, RK. Acquisition, analysis, or interpretation of data: KMA, KB, DSK. Drafting of the manuscript: KMA. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: KMA. Administrative, technical, or material support: KMA, RK. Study supervision: RK.

Funding

No external funding.

Compliance with ethical standards

Disclosures

Drs. Augestad, Butt, Ignjatovic, Keller and Kiran have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2019_7265_MOESM1_ESM.doc (63 kb)
Supplementary material 1 (DOC 63 kb)
464_2019_7265_MOESM2_ESM.doc (72 kb)
Supplementary material 2 (DOC 72 kb)
464_2019_7265_MOESM3_ESM.csv (242 kb)
Supplementary material 3 (CSV 242 kb)

References

  1. 1.
    Schwellnus H, Carnahan H (2013) Peer-coaching with health care professionals: what is the current status of the literature and what are the key components necessary in peer-coaching? A scoping review. Med Teach 36:38–46.  https://doi.org/10.1177/0193945909342878 CrossRefPubMedGoogle Scholar
  2. 2.
    Knol J, Keller DS (2018) Cognitive skills training in digital era: a paradigm shift in surgical education using the TaTME model. The Surgeon.  https://doi.org/10.1016/j.surge.2018.03.008 CrossRefPubMedGoogle Scholar
  3. 3.
    Reznick RK, MacRae H (2006) Teaching surgical skills–changes in the wind. N Engl J Med 355:2664–2669.  https://doi.org/10.1056/NEJMra054785 CrossRefPubMedGoogle Scholar
  4. 4.
    Jackson PG, Tarpley J (2009) How long does it take to train a surgeon? BMJ 339:1–3Google Scholar
  5. 5.
    Bilimoria KY, Chung JW, Hedges LV, Dahlke AR, Love R, Cohen ME, Tarpley J, Mellinger J, Mahvi DM, Kelz RR, Ko CY, Hoyt DB, Lewis FH (2015) Development of the flexibility in duty hour requirements for surgical trainees (FIRST) trial protocol: a national cluster-randomized trial of resident duty hour policies. JAMA Surg 151:273.  https://doi.org/10.1001/jamasurg.2015.4990 CrossRefGoogle Scholar
  6. 6.
    Greenberg CC, Ghousseini HN, Pavuluri Quamme SR, Beasley HL, Wiegmann DA (2015) Surgical coaching for individual performance improvement. Ann Surg 261:32–34.  https://doi.org/10.1097/SLA.0000000000000776 CrossRefPubMedGoogle Scholar
  7. 7.
    Hu Y-Y, Mazer LM, Yule SJ, Arriaga AF, Greenberg CC, Lipsitz SR, Gawande AA, Smink DS (2017) Complementing operating room teaching with video-based coaching. JAMA Surg 152:318.  https://doi.org/10.1001/jamasurg.2016.4619 CrossRefPubMedGoogle Scholar
  8. 8.
    Augestad KM, Han H, Paige J, Ponsky T, Schlachta CM, Dunkin B, Mellinger J (2017) Educational implications for surgical telementoring: a current review with recommendations for future practice, policy, and research. Surg Endosc.  https://doi.org/10.1007/s00464-017-5690-y CrossRefPubMedGoogle Scholar
  9. 9.
    Dimick JB, Scott JW (2019) A video is worth a thousand operative notes. JAMA Surgery.  https://doi.org/10.1001/jamasurg.2018.5247 CrossRefPubMedGoogle Scholar
  10. 10.
    van de Graaf FW, Lange MM, Spakman JI, van Grevenstein WMU, Lips D, de Graaf EJR, Menon AG, Lange JF (2019) Comparison of systematic video documentation with narrative operative report in colorectal cancer surgery. JAMA Surg.  https://doi.org/10.1001/jamasurg.2018.5246 CrossRefPubMedGoogle Scholar
  11. 11.
    Celentano V, Smart N, McGrath J, Cahill RA, Spinelli A, Obermair A, Hasegawa H, Lal P, Almoudaris AM, Hitchins CR, Pellino G, Browning MG, Ishida T, Luvisetto F, Cingiloglu P, Gash K, Harries R, Harji D, Di Candido F, Cassinotti E, McDermott FD, Berry JEA, Battersby NJ, Platt E, Campain NJ, Keeler BD, Boni L, Gupta S, Griffith JP, Acheson AG, Cecil TD, Coleman MG (2018) LAP-VEGaS practice guidelines for reporting of educational videos in laparoscopic surgery. Ann Surg 268:920–926.  https://doi.org/10.1097/SLA.0000000000002725 CrossRefPubMedGoogle Scholar
  12. 12.
    Ritter EM (2018) Invited editorial LAP-VEGaS practice guidelines for video-based education in surgery: content is just the beginning. Ann Surg 268:927–929.  https://doi.org/10.1097/SLA.0000000000003041 CrossRefPubMedGoogle Scholar
  13. 13.
    Birkmeyer JD, Finks JF, Birkmeyer NJO (2015) Surgical skill and complication rates after bariatric surgery. N Engl J 369:1434–1442.  https://doi.org/10.1001/jamasurg.2015.4442 CrossRefGoogle Scholar
  14. 14.
    Greenberg CC, Dombrowski J, Dimick JB (2016) Video-based surgical coaching. JAMA Surg 151:282.  https://doi.org/10.1001/jamasurg.2015.4442 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Moher D (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264.  https://doi.org/10.7326/0003-4819-151-4-200908180-00135 CrossRefGoogle Scholar
  16. 16.
    Cummings PC (2011) Arguments for and against standardized mean differences (effect sizes). JAMA Pediatr 165:1–5Google Scholar
  17. 17.
    Trehan A (2015) The impact of feedback of intraoperative technical performance in surgery:a systematic review. BMJ Open 5:1–5.  https://doi.org/10.1136/bmjopen-2014 CrossRefGoogle Scholar
  18. 18.
    Miskovic D (2010) Systematic review on mentoring and simulation in laparoscopic colorectal surgery. Ann Surg.  https://doi.org/10.1097/SLA.0b01r3e3181f662e5 CrossRefPubMedGoogle Scholar
  19. 19.
    Gagnon L-H, Abbasi N (2017) Systematic review of randomized controlled trials on the role of coaching in surgery to improve learner outcomes. AJS 216:140–146.  https://doi.org/10.1016/j.amjsurg.2017.05.003 CrossRefGoogle Scholar
  20. 20.
    Ahmet A, Gamze K, Rustem M, Sezen KA (2018) Is video-based education an effective method in surgical education? A systematic review. J Surg Educ.  https://doi.org/10.1016/j.jsurg.2018.01.014 CrossRefPubMedGoogle Scholar
  21. 21.
    Szasz P, Louridas M, Harris KA, Aggarwal R, Grantcharov TP (2015) Assessing technical competence in surgical trainees: a systematic review. Ann Surg 261:1046–1055.  https://doi.org/10.1097/SLA.0000000000000866 CrossRefPubMedGoogle Scholar
  22. 22.
    Egedovo A (2017) A systematic review to assess the effectiveness of web based training video for laparoscopy surgery. Int J Res 5:1–21.  https://doi.org/10.5281/zenodo.1043362 CrossRefGoogle Scholar
  23. 23.
    Dawe SR, Windsor JA, Broeders JAJL, Cregan PC, Hewett PJ, Maddern GJ (2014) A systematic review of surgical skills transfer after simulation-based training. Ann Surg 259:236–248.  https://doi.org/10.1097/SLA.0000000000000245 CrossRefPubMedGoogle Scholar
  24. 24.
    Alameddine MB, Englesbe MJ, Waits SA (2018) A video-based coaching intervention to improve surgical skill in fourth-year medical students. J Surg Educ.  https://doi.org/10.1016/j.jsurg.2018.04.003 CrossRefPubMedGoogle Scholar
  25. 25.
    Autry AM, Knight S, Lester F, Dubowitz G, Byamugisha J, Nsubuga Y, Muyingo M, Korn A (2013) Teaching surgical skills using video internet communication in a resource-limited setting. Obstet Gynecol 122:127–131.  https://doi.org/10.1097/AOG.0b013e3182964b8c CrossRefPubMedGoogle Scholar
  26. 26.
    Backstein D, Agnidis Z (2005) Effectiveness of repeated video feedbackin the acquisition of a surgical technical skill. Can J Surg 48:1–6Google Scholar
  27. 27.
    Bochenska K, Milad MP, DeLancey JO, Lewicky-Gaupp C (2018) Instructional video and medical student surgical knot-tying proficiency: randomized controlled trial. JMIR Med Educ 4:e9.  https://doi.org/10.1016/S0002-9610(98)00289-X CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Bonrath EM, Dedy NJ, Gordon LE, Grantcharov TP (2015) Comprehensive surgical coaching enhances surgical skill in the operating room. Ann Surg 262:205–212.  https://doi.org/10.1097/SLA.0000000000001214 CrossRefPubMedGoogle Scholar
  29. 29.
    Carter SC, Chiang A, Shah G, Kwan L, Montgomery JS, Karam A, Tarnay C, Guru KA, Hu JC (2015) Video-based peer feedback through social networking for robotic surgery simulation. Ann Surg 261:870–875.  https://doi.org/10.1097/SLA.0000000000000756 CrossRefPubMedGoogle Scholar
  30. 30.
    Crawshaw BP, Steele SR, Lee EC, Delaney CP, Mustain WC, Russ AJ, Shanmugan S, Champagne BJ (2016) Failing to prepare is preparing to fail. Dis Colon Rectum 59:28–34.  https://doi.org/10.1097/DCR.0000000000000503 CrossRefPubMedGoogle Scholar
  31. 31.
    Cole SJ, Mackenzie H, Ha J, Hanna GB, Miskovic D (2013) Randomized controlled trial on the effect of coaching in simulated laparoscopic training. Surg Endosc 28:979–986.  https://doi.org/10.1097/SLA.0b013e318176bf24 CrossRefPubMedGoogle Scholar
  32. 32.
    Farquharson AL, Cresswell AC, Beard JD, Chan P (2013) Randomized trial of the effect of video feedback on the acquisition of surgical skills. Br J Surg 100:1448–1453.  https://doi.org/10.1016/S0039-6060(99)70173-X CrossRefPubMedGoogle Scholar
  33. 33.
    Jensen AR, Wright AS, Levy AE, McIntyre LK, Foy HM, Pellegrini CA, Horvath KD, Anastakis DJ (2009) Acquiring basic surgical skills: is a faculty mentor really needed? Am J Surg 197:82–88.  https://doi.org/10.1016/j.amjsurg.2008.06.039 CrossRefPubMedGoogle Scholar
  34. 34.
    Jowett N, LeBlanc V, Xeroulis G, MacRae H, Dubrowski A (2007) Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg 193:237–242.  https://doi.org/10.1016/j.amjsurg.2006.11.003 CrossRefPubMedGoogle Scholar
  35. 35.
    Karam MD, Thomas GW, Koehler DM, Westerlind BO, Lafferty PM, Ohrt GT, Marsh JL, Van Heest AE, Anderson DD (2015) Surgical coaching from head-mounted video in the training of fluoroscopically guided articular fracture surgery. J Bone Joint Surg Am 97:1031–1039.  https://doi.org/10.2106/JBJS.N.00748 CrossRefPubMedGoogle Scholar
  36. 36.
    Nousiainen M, Brydges R, Backstein D, Dubrowski A (2008) Comparison of expert instruction and computer-based video training in teaching fundamental surgical skills to medical students. Surgery 143:539–544.  https://doi.org/10.1016/j.surg.2007.10.022 CrossRefPubMedGoogle Scholar
  37. 37.
    Pape-Koehler C, Immenroth M, Sauerland S, Lefering R, Lindlohr C, Toaspern J, Heiss M (2013) Multimedia-based training on Internet platforms improves surgical performance: a randomized controlled trial. Surg Endosc 27:1737–1747.  https://doi.org/10.1111/j.1445-2197.2008.04828.x CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Porte MC, Xeroulis G, Reznick RK, Dubrowski A (2007) Verbal feedback from an expert is more effective than self-accessed feedback about motion efficiency in learning new surgical skills. Am J Surg 193:105–110.  https://doi.org/10.1016/j.amjsurg.2006.03.016 CrossRefPubMedGoogle Scholar
  39. 39.
    Palter VN, Beyfuss KA, Jokhinio AR, Ashmalla S (2016) Peer coaching to teach faculty surgeons an advanced laparoscopic skill: a randomized controlled trial. Surgery 160:1392–1399.  https://doi.org/10.1016/j.surg.2016.04.032 CrossRefPubMedGoogle Scholar
  40. 40.
    Rindos NB, Wroble-Biglan M, Ecker A, Lee TT, Donnellan NM (2017) Impact of video coaching on gynecologic resident laparoscopic suturing: a randomized controlled trial. J Minim Invasive Gynecol.  https://doi.org/10.1016/j.jmig.2016.12.020 CrossRefPubMedGoogle Scholar
  41. 41.
    Rogers D (2000) The impact of external feedback on computer-assisted learning for surgical technical skill training. Am J Surg 179:341–343CrossRefGoogle Scholar
  42. 42.
    Singh P, Aggarwal R, Tahir M, Pucher PH, Darzi A (2015) A randomized controlled study to evaluate the role of video-based coaching in training laparoscopic skills. Ann Surg 261:862–869.  https://doi.org/10.1097/SLA.0000000000000857 CrossRefPubMedGoogle Scholar
  43. 43.
    Soucisse ML, Boulva K, Sideris L, Drolet P, Morin M, Dubé P (2016) Video coaching as an efficient teaching method for surgical residents—a randomized controlled trial. J Surg Educ.  https://doi.org/10.1016/j.jsurg.2016.09.002 CrossRefPubMedGoogle Scholar
  44. 44.
    Summers AN (1999) Acquisition of surgical skills: a randomized trial of didactic, videotape, and computer-based training. Surgery 126:330–336CrossRefGoogle Scholar
  45. 45.
    Lwin AT, Lwin T, Naing P, Oo Y, Kidd D, Cerullo M, Posen J, Hlaing K, Yenokyan G, Thinn KK, Soe ZW, Stevens KA (2017) Self-directed interactive video-based instruction versus instructor-led teaching for myanmar house surgeons: a randomized, noninferiority trial. J Surg Educ.  https://doi.org/10.1016/j.jsurg.2017.06.004 CrossRefPubMedGoogle Scholar
  46. 46.
    van Det MJ, Meijerink WJHJ, Hoff C, Middel LJ, Koopal SA, Pierie JPEN (2011) The learning effect of intraoperative video-enhanced surgical procedure training. Surg Endosc 25:2261–2267.  https://doi.org/10.1007/s00464-006-0149-6 CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Xeroulis GJ, Park J, Moulton C-A, Reznick RK, LeBlanc V, Dubrowski A (2007) Teaching suturing and knot-tying skills to medical students: a randomized controlled study comparing computer-based video instruction and (concurrent and summary) expert feedback. Surgery 141:442–449.  https://doi.org/10.1016/j.surg.2006.09.012 CrossRefPubMedGoogle Scholar
  48. 48.
    Martin J, Regehr G, Reznick RK, Macrae H, Murnaghan J, Hutchinson C, Brown M (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273–278.  https://doi.org/10.1046/j.1365-2168.1997.02502.x CrossRefPubMedGoogle Scholar
  49. 49.
    Reznick R (1997) Testing technical skill via an innovative “bench station” examination. Am J Surg 173:1–5CrossRefGoogle Scholar
  50. 50.
    Zevin B, Bonrath EM, Aggarwal R, Dedy NJ, Ahmed N, Grantcharov TP (2013) Development, feasibility, validity, and reliability of a scale for objective assessment of operative performance in laparoscopic gastric bypass surgery. J Am Coll Surg 216:955–965.e8.  https://doi.org/10.1016/j.jamcollsurg.2013.01.003 CrossRefPubMedGoogle Scholar
  51. 51.
    Bonrath EM, Zevin B, Dedy NJ, Grantcharov TP (2013) Error rating tool to identify and analyse technical errors and events in laparoscopic surgery. Br J Surg 100:1080–1088.  https://doi.org/10.1007/s00464-002-8828-4 CrossRefPubMedGoogle Scholar
  52. 52.
    Husslein H, Shirreff L, Shore EM, Lefebvre GG, Grantcharov TP (2015) The generic error rating tool: a novel approach to assessment of performance and surgical education in gynecologic laparoscopy. J Surg Educ 72:1259–1265.  https://doi.org/10.1016/j.jsurg.2015.04.029 CrossRefPubMedGoogle Scholar
  53. 53.
    Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondré K, Stanbridge D, Fried GM (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190:107–113.  https://doi.org/10.1016/j.amjsurg.2005.04.004 CrossRefPubMedGoogle Scholar
  54. 54.
    Goh AC, Goldfarb DW, Sander JC, Miles BJ, Dunkin BJ (2012) Outcomes/epidemiology/socioecnomics global evaluative assessment of robotic skills: validation of a clinical assessment tool to measure robotic surgical skills. J Urol 187:247–252.  https://doi.org/10.1016/j.juro.2011.09.032 CrossRefPubMedGoogle Scholar
  55. 55.
    Larson JL, Williams RG, Ketchum J, Boehler ML, Dunnington GL (2005) Feasibility, reliability and validity of an operative performance rating system for evaluating surgery residents. Surgery 138:640–649.  https://doi.org/10.1016/j.surg.2005.07.017 CrossRefPubMedGoogle Scholar
  56. 56.
    Miskovic D, Wyles SM, Carter F, Coleman MG, Hanna GB (2010) Development, validation and implementation of a monitoring tool for training in laparoscopic colorectal surgery in the English National Training Program. Surg Endosc 25:1136–1142.  https://doi.org/10.1007/s00464-008-0088-5 CrossRefPubMedGoogle Scholar
  57. 57.
    Cole SJ, Mackenzie H, Ha J, Hanna GB, Miskovic D (2013) Randomized controlled trial on the effect of coaching in simulated laparoscopic training. Surg Endosc 28:979–986.  https://doi.org/10.1097/SLA.0b013e318176bf24 CrossRefPubMedGoogle Scholar
  58. 58.
    Miskovic D, Ni M, Wyles SM, Kennedy RH, Francis NK, Parvaiz A, Cunningham C, Rockall TA, Gudgeon AM, Coleman MG, Hanna GB (2013) Is competency assessment at the specialist level achievable? A study for the national training programme in laparoscopic colorectal surgery in England. Ann Surg 257:476–482.  https://doi.org/10.1097/SLA.0b013e318275b72a CrossRefPubMedGoogle Scholar
  59. 59.
    Greenberg CC, Ghousseini HN, Pavuluri Quamme SR, Beasley HL, Frasier LL, Brys NA, Dombrowski JC, Wiegmann DA, Wisconsin Surgical Coaching Program (2017) A statewide surgical coaching program provides opportunity for continuous professional development. Ann Surg 267:868–873.  https://doi.org/10.1097/SLA.0000000000002341 CrossRefGoogle Scholar
  60. 60.
    Hu Y-Y, Mazer LM, Yule SJ, Arriaga AF, Greenberg CC, Lipsitz SR, Gawande AA, Smink DS (2017) Complementing operating room teaching with video-based coaching. JAMA Surg 152:318.  https://doi.org/10.1001/jamasurg.2016.4619 CrossRefPubMedGoogle Scholar
  61. 61.
    Beasley HL, Ghousseini HN, Wiegmann DA, Brys NA, Pavuluri Quamme SR, Greenberg CC (2017) Strategies for building peer surgical coaching relationships. JAMA Surg 152:e165540.  https://doi.org/10.1001/jamasurg.2016.5540 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Postgraduate Surgical EducationUniversity Hospital North NorwayTromsöNorway
  2. 2.Department of GI SurgerySandnessjøen Regional HospitalSandnessjøenNorway
  3. 3.Division of Colorectal SurgeryColumbia University Medical CenterNew YorkUSA
  4. 4.Department of GI SurgeryNordlandssykehusetBodøNorway
  5. 5.Department of GI SurgeryAkershus University HospitalOsloNorway
  6. 6.Institute of Clinical MedicineUniversity of OsloOsloNorway

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