Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room

Bonrath, Esther M.; Dedy, Nicolas J.; Gordon, Lauren; Grantcharov, Teodor P.

doi:10.1097/sla.0000000000001214

Cited by 211 publications

(131 citation statements)

References 42 publications

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“…We have also shown that our dynamic extension of Feature Signatures (DFS) can achieve slightly better retrieval performance than static FS-which are known to work well for content-based retrieval in medical videos [8] -but cannot outperform HMG for our dataset. To the best of our knowledge, we are the first to focus on content similarity search in video archives of gynecologic laparoscopy, with the ultimate goal to support the surgical quality assessment process [11,22]. This work is only a first step in this domain, which would also benefit from semantic content classification approaches, which we want to investigate in the near future.…”

Section: Discussionmentioning

confidence: 99%

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Video retrieval in laparoscopic video recordings with dynamic content descriptors

Schoeffmann

Husslein

Kletz

et al. 2017

Multimed Tools Appl

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In the domain of gynecologic surgery an increasing number of surgeries are performed in a minimally invasive manner. These laparoscopic surgeries require specific psychomotor skills of the operating surgeon, which are difficult to learn and teach. This is the reason why an increasing number of surgeons promote checking video recordings of laparoscopic surgeries for the occurrence of technical errors with surgical actions. This manual surgical quality assessment (SQA) process, however, is very cumbersome and timeconsuming when carried out without any support from content-based video retrieval. Appl (2018) 77:16813-16832 Descriptor) that can be effectively used to find similar segments in a laparoscopic video database and thereby help surgeons to more quickly inspect other instances of a given error scene. We evaluate the retrieval performance of MIDD with surgical actions from gynecologic surgery in direct comparison to several other dynamic content descriptors. We show that the MIDD descriptor significantly outperforms the state-of-the-art in terms of retrieval performance as well as in terms of runtime performance. Additionally, we release the manually created video dataset of 16 classes of surgical actions from medical laparoscopy to the public, for further evaluations.

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Section: Discussionmentioning

confidence: 99%

“…Additional error analysis allows the detection of the surgeon's specific strengths and respective weaknesses. The application of this kind of post-hoc video analysis of surgical videos through comprehensive surgical coaching [11] significantly improves the performance of trained surgeons [9,16,32].…”

Section: Related Workmentioning

confidence: 99%

Video retrieval in laparoscopic video recordings with dynamic content descriptors

Schoeffmann

Husslein

Kletz

et al. 2017

Multimed Tools Appl

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“…The few publications on coaching for surgeons are quite recent and emphasize performance improvement in practitioners as illustrated in the Gawande example. [42][43][44] However, if the principles of effective coaching can be successfully applied to practicing surgeons with improvement in operative proficiency, extrapolation to resident education would be logical and rational.…”

Section: Teaching Operative Skillsmentioning

confidence: 98%

The Future of Plastic Surgery Resident Education

Luce

2016

Plastic and Reconstructive Surgery

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“…There is increasing interest in mentoring and coaching to improve technical and cognitive skills such as judgment and DM, 48,49 including the potential of procedural videos to be used for safe and timely coaching. 48,49 Specifically, the current repository of operative videos coupled with recorded expert decisions can now be used to better train and assess residents in operative DM. Residents can now be subjected to these operative scenarios and their judgment compared and contrasted with the operative decisions of the expert panel.…”

Section: Discussionmentioning

confidence: 99%

“Contemplating the Next Maneuver”

et al. 2017

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Objective: To investigate differences in the quality, confidence, and consistency of intraoperative surgical decision making (DM) and decision systems that operators use using functional neuroimaging AQ4. Summary Background Data: Novices are hypothesized to use conscious analysis (effortful DM) leading to activation across the dorsolateral prefrontal cortex, whereas experts are expected to use unconscious automation (habitual DM) in which decisions are recognition-primed and prefrontal cortex independent. Methods: A total of 22 subjects (10 medical student novices, 7 residents, and 5 attendings) reviewed simulated laparoscopic cholecystectomy videos, determined the next safest operative maneuver upon video termination (10 s), and reported decision confidence. Video paradigms either declared (''primed'') or withheld (''unprimed'') the next operative maneuver. Simultaneously, changes in cortical oxygenated hemoglobin and deoxygenated hemoglobin inferring prefrontal activation were recorded using Optical Topography. Decision confidence, consistency (primed vs unprimed), and quality (script concordance) were assessed. Results: Attendings and residents were significantly more certain (P < 0.001), and decision quality was superior (script concordance: attendings ¼ 90%, residents ¼ 78.3%, and novices ¼ 53.3%). Decision consistency was significantly superior in experts (P < 0.001) and residents (P < 0.05) than novices (P ¼ 0.183). During unprimed DM, novices showed significant activation of the dorsolateral prefrontal cortex, whereas this activation pattern was not observed among residents and attendings. During primed DM, significant activation was not observed in any group. Conclusions: Expert DM is characterized by improved quality, consistency, and confidence. The findings imply attendings use a habitual decision system, whereas novices use an effortful approach under uncertainty. In the presence of operative cues (primes), novices disengage the prefrontal cortex and seem to accept the observed operative decision as correct.

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Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room

Abstract: Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training.

Cited by 211 publications

References 42 publications

Video retrieval in laparoscopic video recordings with dynamic content descriptors

Video retrieval in laparoscopic video recordings with dynamic content descriptors

The Future of Plastic Surgery Resident Education

“Contemplating the Next Maneuver”

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