Randomized Control Trial Evaluating Different Modalities of Real-Time Surgical Feedback.
Academic Article
Overview
abstract
INTRODUCTION:: Surgical training is a constant exchange between trainers and trainees, and intraoperative surgical feedback is an integral part of learning. New technologies in robotic surgery allow for the delivery of visual aid and verbal feedback intraoperatively, but it has not yet been determined if feedback type affects the trainee learning process. METHODS:: 49 novice participants were recruited and randomized into four feedback groups: Verbal, Visual, Combination of verbal/visual, and no feedback (Control). Participants completed a suturing task three times (pre-test, feedback, post-test). Suturing videos were retrospectively graded utilizing a standard rubric, and performance scores were compared across feedback groups utilizing hierarchical modeling. RESULTS:: Each group had similar pre-test performance (p>0.05). Comparison between pre-test and post-test performance revealed statistically significant improvements in performance across feedback groups for Retraction and Cinching, but Control did not improve (interaction test: p<0.001). Verbal and Visual demonstrated significant improvement in Spacing as compared to Control (p=0.004 and p=0.002). During the feedback round, Combination received statistically significantly less feedback as compared to Verbal and Visual before consistently utilizing the correct technique for Retraction (p<0.001, p=0.013). Combination also received statistically significantly less feedback as compared to Verbal for Cinching (p=0.006). Finally, participants in Visual and Combination required significantly less Clarification on the delivered feedback compared to those in Verbal (p=0.004, p=0.001). CONCLUSION:: Real-time surgical feedback—regardless of type—allows for marked improvement in correct technique. Additionally, a combination of both visual and verbal feedback may help surgical trainees learn more efficiently than verbal or visual feedback alone.
