Does livestreaming surgical education have the future? Development and participant evaluation of a national COVID-19 livestreaming initiative

Abstract

Backgrounds COVID-19 related reduction of surgical procedures jeopardizes learning on the job of surgical residents. Many educators resorted to digital resources in the search for alternatives. However, these resources are often limited to the extent they offer resident-surgeon interaction like a joint surgical performance does. Here we present a roadmap of livestreaming surgical procedures, and evaluate how surgical livestreams on human cadavers address the unmet educational needs of surgical residents in our Dutch nationwide initiative. Methods Technical and organizational feasibility, and definition of outcome deliverables for the livestream series and per livestream were essential in livestream development. Faculty selected interventions, lecture contents, and participant preparations. Appropriate location, technical setup, and support were imperative for a stable, high-quality stream with integrated interaction, while maintaining digital privacy. A survey was sent to livestream participants to evaluate each livestream, and allow for constant improvement during the broadcasting of the series. Only surveys which were completed by surgical residents were included in the analysis of this study. Results Each livestream attracted 139–347 unique viewers and a total of 307 surveys were completed by participants (response rate of 23–38% per livestream). Sixty percent of surveys ( n = 185) were completed by surgical residents. Livestreams were highly valued (appreciation 7.7 ± 1.1 and recommendation 8.6 ± 1.1), especially the live procedures combined with interaction and theoretical backgrounds. Criticized were technical difficulties and timing of the livestreams between 5 and 7 pm, which interfered with clinical duties. Conclusion Livestreaming surgical procedures on human cadavers is a valid and valued solution to augment resident education. Digital privacy and a stable, high-quality interactive stream are essential, as are appropriate moderation and relevant lectures. While livestreaming cannot replace hands-on training in the operating room, it enables surgeon-resident interaction which is key in education—and missed in pre-recorded surgical procedures which are currently available online.

Surgical education in the post-COVID era: an EAES DELPHI-study

“…The current web-based modified Delphi study establishes that the negative effects of the COVID-19 pandemic on surgical training were indeed perceived as severe within the EAES membership. Clinical training and assessment were reportedly > 50% affected, while wet lab and dry lab access Video-based training resources have long been of interest for surgeons, and were the go-to resource of educators during the pandemic [8][9][10]. Participants in the current study preferred live videos over pre-recorded videos of surgery, indicating their preference to replicate the experience that residents have while standing at the table in the OR.…”

“…Video-based training resources have long been of interest for surgeons, and were the go-to resource of educators during the pandemic [ 8 – 10 ]. Participants in the current study preferred live videos over pre-recorded videos of surgery, indicating their preference to replicate the experience that residents have while standing at the table in the OR.…”

“…Participants in the current study preferred live videos over pre-recorded videos of surgery, indicating their preference to replicate the experience that residents have while standing at the table in the OR. Several surgical livestreams were successfully initiated during the pandemic, although there are some ethical, safety, and medico-legal considerations: Informed consent is critical, patient safety can never be compromised to improve the educational value videos, and recording of videos by others should be prevented [ 8 , 11 – 13 ]. It is easier and recommended to safeguard these challenges in pre-recorded videos, although in the current study live videos were better appreciated.…”

“…Additionally, alternative resources should be used to assess technical skills assessments after COVID (recommendation 6). Two recommendations relate to the importance of wet lab and dry lab training (2, 3), four relate to the quality control and accreditation of digital resources (7,9,10,12), and three relate to the importance of using digital resources as compensation for limited training opportunities (8,11,13).…”

Comprehensive qualitative evaluation of the first ever full-time online course for medical students in one middle-income country

“…The greatest challenge for our students was the fact that they missed on practical sessions. While students in some online courses report fair adoption of manual skills [ 1 , 15 ], it is difficult to transfer the tactile experience through screen to undergraduate students [ 16 , 17 ]. Moreover, both students and teachers in this study confirmed that they had certain, albeit rare, technical difficulties when having online classes.…”