A Multi-centre, Randomized Controlled Trial to Assess Video-based Surgical Coaching in Gynecology.

Abstract

Objective: To evaluate the effect of video-based coaching on technical skill development in surgical education.

Design: Randomized controlled trial with video-based coaching (intervention group) in addition to standard surgical curriculum or the standard surgical curriculum alone (control group).

Setting: Laparoscopic vaginal vault closure in the operating room at three academic hospitals.

Participants: Senior Obstetrics and Gynecology residents (year 3-5) on their chief resident or gynecologic oncology rotation.

Interventions: All residents were recorded performing laparoscopic closure of the vaginal cuff prior to randomization. Surgical coaching sessions followed the Wisconsin Surgical Coaching Framework over 30 minutes on Zoom with one surgical coach. All residents were recorded subsequently performing the same surgical technical skill. Blinded, expert surgeons performed the video-assessment using the OSATS, GOALS and global rating scale. The mean change in operative time and the mean change in video-assessment score between the two video-recorded attempts was compared between groups. Qualitative semi-structured interviews were conducted to understand the residents' perspective on video-based surgical coaching.

Results: Twenty residents participated with 10 in the coaching and 10 in the control group. Mean operative time to complete the suturing task was reduced by 32.8% (SD = 21.3%) in the coached group vs. 7.2% (SD = 25.1%) in the control group (p=.025). There was no significant change in surgical assessment scores within the coached or control group. Residents identified the core components of a surgical coaching program to include: (1) the resident: focused skill development, (2) the coach: focused on feedback (3) the coaching program: a structured activity. Residents envisioned monthly coaching with the opportunity for deliberate practice, the importance of a positive relationship between the coach and coachee, and the importance of faculty development in surgical coaching.

Conclusion: Video-based surgical coaching is an effective tool to enhance technical skill development in surgical education.

Data sharing: De-identified study data is available at Swift, Brenna (2024), "Video-based Coaching in Gynecology", Mendeley Data, V1, 10.17632/4h34g58kkn.1 https://data.mendeley.com/datasets/4h34g58kkn/1. This trial was registered with Clinicaltrials.gov ID: NCT05086783 on Sept 28, 2021 and can be found at https://clinicaltrials.gov/study/NCT05086783?term=NCT05086783&rank=1#study-record-dates.