Randomized controlled trial on the effect of coaching in simulated laparoscopic training

Abstract

Clinically relevant markers of proficiency including error reduction, understanding of surgical strategy, and surgical quality are significantly improved with structured coaching. Path length and number of movements representing merely manual skills are developed with task repetition rather than influenced by coaching. Structured coaching may represent a key component in the acquisition of procedural skills.

Systematic review of coaching to enhance surgeons' operative performance

“…Table I presents an overview of the 23 articles reviewed (ie, target group, total n, study design, coaching target, risk of bias, comments). Four studies 22,26,27,32 were randomized controlled trials (RCTs) that compared the intervention group with a control group. Eighteen studies 6,[17][18][19][20][21][23][24][25][28][29][30][31][33][34][35][36][37] were observational studies using a single group prepost design, and one study was a descriptive study analyzing audio-recorded video coaching.…”

“…6,25,27,32 Overall, coaching was considered to be effective in 15 of the 23 studies. 6,[17][18][19][22][23][24][25][27][28][29]32,[35][36][37] Perception, attitudes, and opinions. The first level of the Kirkpatrick model of training evaluation consists of the learner's reaction to the intervention.…”

“…Ten studies reported outcomes related to technical skills: 4 RCTs 22,26,27,32 and 6 observational studies. 9,19,24,28,29,35 Outcomes measured included technical errors, suture/knot tying time and skills, number of operative movements, path length, field exposure, progression of the operation, and inadequate motion, 19,22,24,[26][27][28][29]32,35 with 2 studies using a validated assessment tool. 19,28 The 4 RCTs resulted in a High strength of evidence according to GRADE with a mean MERSQI score of 13.1 compared with the 6 observational studies resulting in a Very Low grading and a lower mean 24,[27][28][29] Interventions varied in duration ranging from one-time sessions to repeating sessions over weeks.…”

Operator experience determines performance in a simulated computer-based brain tumor resection task

“…Furthermore, this study also expands previous work by measuring clinically relevant variables in longer surgical tasks, assessing learning curve data by repeating the same surgical task on different days to evaluate changes in performance over time, and evaluating the effect of coaching on improving surgical performance [12,13]. In non-neurosurgical simulations, coaching and repeated trials has been shown to improve outcomes and decrease operative error [20,21]. Identification of similar findings for brain surgery simulators would help to promote the use of these simulators as a training tool.…”

Virtual and Augmented Reality in Medical Education

“…Information on handling tissue, handling tools, time, and movement efficiency are obtained during the simulation and are processed to produce metrics [2,20]. It has demonstrated construct validity, predictive validity, and transferability of technical skills, especially when combined with supervision by the instructors [21,23].…”