Live surgical education: a perspective from the surgeons who perform it

Abstract

Objective• To evaluate the experience and views regarding live surgical broadcasts (LSB) among European urologists attending the European Association of Urology Robotic Urology Society (ERUS) congress in September 2012. Materials and Methods• An anonymous survey was distributed via email inviting the participants of the ERUS congress with experience of LSB to share their opinions about LSB.• The outcomes measured included; personal experience of LSB, levels of anxiety faced and the perceived surgical quality.• The impact of factors, such as communication/teamworking, travel fatigue and lack of specific equipment were also evaluated. Results• In all, 106 surgeons responded with 98 (92.5%) reporting personal experience of LSB; 6.5% respondents noted 'significant anxiety' increasing to 19.4% when performing surgery away from home (P < 0.001).• Surgical quality was perceived as 'slightly worse' and 'significantly worse' by 16.1% and 2.2%, which deteriorated further to 23.9% and 3.3% respectively in a 'foreign' environment (P = 0.005).• In all, 10.9% of surgeons 'always' brought their own surgical team compared with 37% relying on their host institution;2.4% raised significant concerns with their team and 18.8% encountered significantly more technical difficulties.• Lack of specific equipment (10.3%), language difficulties (6.2%) and jet lag (7.3%) were other significant factors reported.• In all, 75% of surgeons perceived the audience wanted a slick demonstration; however, 52.2% and 42.4% respectively also reported the audience wished the surgeon to struggle or manage a complication during a LSB. Conclusions• A small proportion of surgeons had significantly heightened anxiety levels and lower perceived performance during LSB, which in a 'foreign' environment seemed to affect a greater proportion of surgeons. • Various factors appear to impact surgical performance raising concerns about the appropriateness of unregulated LSB as a teaching method.• To mitigate these concerns, surgeons' performing live surgery feel that the operation needs to be well planned using appropriate equipment; with many considering bringing their own team or operating from home on a video link.

Systematic review of live surgical demonstrations and their effectiveness on training

“…Thirteen guidelines, position statements and articles relating to guidelines placed by Surgical Societies were identified ( Table ; Table S3 , supporting information). The first guidelines were developed following the death of a patient in Japan during a live transmission in 2007.…”

Outcome from 5-year live surgical demonstrations in urinary stone treatment: are outcomes compromised?

“…Khan et al demonstrated higher anxiety levels in surgeons operating in a foreign environment. Difficult communication in the operative theatre, equipment issues, and travel-fatigue appeared to have impact on the surgical performance [ 4 ]. Duty et al performed a survey investigating 90 American Association of Genitourinary Surgeons members.…”

Demystifying surgery live on TV

“…In a survey of 106 European urologists who had performed live broadcasts 7% reported “significant anxiety” during the broadcast, and 16% thought that their performance had been “slightly worse,”7 although research indicates that complication rates were consistent 891011. Still, at least two patients have died in association with live broadcasts,1213 and most Japanese and US surgical societies have banned the practice 12.…”