The impact of feedback of intraoperative technical performance in surgery: a systematic review

Abstract

ObjectivesIncreasing patient demands, costs and emphasis on safety, coupled with reductions in the length of time surgical trainees spend in the operating theatre, necessitate means to improve the efficiency of surgical training. In this respect, feedback based on intraoperative surgical performance may be beneficial. Our aim was to systematically review the impact of intraoperative feedback based on surgical performance.SettingMEDLINE, Embase, PsycINFO, AMED and the Cochrane Database of Systematic Reviews were searched. Two reviewers independently reviewed citations using predetermined inclusion and exclusion criteria. 32 data-points per study were extracted.ParticipantsThe search strategy yielded 1531 citations. Three studies were eligible, which comprised a total of 280 procedures by 62 surgeons.ResultsOverall, feedback based on intraoperative surgical performance was found to be a powerful method for improving performance. In cholecystectomy, feedback led to a reduction in procedure time (p=0.022) and an improvement in economy of movement (p<0.001). In simulated laparoscopic colectomy, feedback led to improvements in instrument path length (p=0.001) and instrument smoothness (p=0.045). Feedback also reduced error scores in cholecystectomy (p=0.003), simulated laparoscopic colectomy (p<0.001) and simulated renal artery angioplasty (p=0.004). In addition, feedback improved balloon placement accuracy (p=0.041), and resulted in a smoother learning curve and earlier plateau in performance in simulated renal artery angioplasty.ConclusionsIntraoperative feedback appears to be associated with an improvement in performance, however, there is a paucity of research in this area. Further work is needed in order to establish the long-term benefits of feedback and the optimum means and circumstances of feedback delivery.

Robust Real-Time Detection of Laparoscopic Instruments in Robot Surgery Using Convolutional Neural Networks with Motion Vector Prediction

“…This means that improvement of surgical performance can lead to better outcomes of surgical operations. Surgical performance can be improved through sophisticated remote manipulation of the robot [2][3][4], but surgical feedback also has a positive effect on surgical performance [5]. While manual evaluation methods such as the objective structured assessment of technical skills (OSATS), and the global operative assessment of laparoscopic skills (GOALS) can assess the surgical skills and are beneficial in terms of their improvements, it is both time and labor consuming, because surgeries could last multiple hours [6,7].…”

The effect of metrics-based feedback on acquisition of sonographic skills relevant to performance of ultrasound-guided axillary brachial plexus block

“…However, in other domains of learning, it is evident that skills acquired through simulated training are transferable to clinical practice . Previous studies have shown that the provision of feedback is associated with improved procedure performance in clinical situations . The ultimate goals of any simulation‐based training programme with feedback are to reduce errors and to make performance more consistent.…”

Overview of a novel paediatric surgical simulation‐based medical education programme in Myanmar

“…19 Feedback is essential both for learning, [20][21][22] and for skills development. 23 All of the educational activities in the programme included structured feedback using either the 'Plus/Delta' (+/Δ) feedback model or Pendleton model techniques. 24 Participant feedback was also a key component of the programme evaluation, with this being used for course adaptation and further development.…”