Enhancing Pedicle Screw Fixation Training: A Novel Approach Using Head-mounted Devices for Video-assisted Debriefing.

Abstract

Background: Video-assisted debriefing (VAD) is promising for medical skill training, but its effectiveness requires further exploration. The aim of this study was to investigate the effectiveness of point-of-view VAD in spinal surgery training.

Methods: Forty surgical residents were randomly divided into control and video-assisted (VA) groups, both of which underwent pedicle screw fixation procedures while being graded by a consulting surgeon in terms of their technical skills (primary outcome). On the second day, both groups received verbal debriefing and coaching from a senior consultant surgeon; for the VA group, this step was performed while watching a recorded point-of-view video of the procedure alongside the resident surgeon. Both groups then underwent a new testing round and participated in a questionnaire survey regarding their debriefing experience.

Results: After the debriefing session, the residents in the VA group had significantly greater technical skills than those in the control group (37 ± 9.7 vs. 25 ± 8.5, P < 0.001). The VAD method was better than the traditional method in terms of steps such as recognizing anatomical structures, piloting holes in the bone, tapping, screw insertion and judging the location of the pedicle screws.

Conclusions: VAD is more effective than traditional verbal debriefing for improving residents' surgical skills, particularly for obtaining a more comprehensive understanding of anatomical structures, imitating detailed surgical techniques as well as promoting initiative. However, in terms of mastery of surgical skills, VAD is not significantly beneficial for tactile perception of the surrounding tissue, indicating that a certain amount of practice is still necessary.