Video-based self-assessment enhances laparoscopic skills on a virtual reality simulator: a randomized controlled trial
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and Other Interventional Techniques
Video‑based self‑assessment enhances laparoscopic skills on a virtual reality simulator: a randomized controlled trial Antoine Netter1 · Andy Schmitt2 · Aubert Agostini1 · Patrice Crochet1,3 Received: 1 September 2020 / Accepted: 15 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Hysterectomy rates are decreasing in many countries, and virtual reality (VR) simulators bring new training opportunities for residents. As coaching interventions while training on a simulated complex procedure represents a resource challenge, alternative strategies to improve surgical skills must be investigated. We sought to determine whether self-guided learning using a video-based self-assessment (SA) leads to improved surgical skills in laparoscopic hysterectomy (LH) on a VR simulator. Methods Twenty-four gynecology residents from two university hospitals were randomized into an SA group (n = 12) and a Control group (n = 12). Each participant’s baseline performance on a validated VR basic task was assessed. Both groups then performed three virtually simulated LHs during which the participants received no guidance nor feedback. Following each LH, the SA group participants rated the video of their own performance using a generic and a procedure-specific rating scale, while the Control group participants watched an LH video demonstration. The LH videos of both groups’ participants were blindly reviewed and rated by expert surgeons, using modified Objective Structured Assessment of Technical Skills scores (OSATS). Objective metrics recorded by the VR simulator were also compared. Results There was no difference between the groups’ baseline performances on the VR basic task. For the first LH, the OSATS-derived scores did not differ between SA and Control groups (9 [7–13] versus 9 [8–14]; p = 0.728). For the third LH, the OSATS-derived scores were higher for the SA group than for the Control group (17 [15–21] versus 15 [11–17], p = 0.039). Between the two groups, the objective metrics did not differ from the first to the third LH. Conclusions The use of a structured video-based SA leads to improved procedural skills in LH on a VR simulator compared to watching benchmark expert performance, in a population of residents with moderate experience in the operating room. Keywords Laparoscopic hysterectomy · Residency · Simulation · Surgery · Training · Self-assessment · Self-guided learning Rethinking the way we teach surgical trainees to perform complex procedures is necessary and challenging [1]. University hospitals are compelled to deal with both the always increasing standards of patients’ safety and the need to guide surgical trainees, so they can eventually perform procedures * Patrice Crochet [email protected] 1
Department of Obstetrics and Gynecology, Hôpital de la Conception, Aix Marseille University, 147 Boulevard Baille, 13005 Marseille, France
2
Department of Obstetrics and Gynecology, Centre Hospitalier du Pays D’Ai
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