Introduction: Telementoring(TM) is an emerging tool that enables experts to provide consultation to other surgeons remotely. It has not been studied in the simulation environment. Simulation allows residents to train independently to gain proficiency. The aim of this study is to assess the effectiveness of distant telementoring in a simulated mock operating room to identify technical error and shorten the pathway to proficiency.
Methods: Surgical residents were randomized into two groups. The control group (n=9) performed a baseline laparoscopic cholecystectomy on a virtual reality system (METI, SurgicalSim) in a mock operating room followed by two additional trials. The telementored group (n=6) performed a baseline trial, followed by a telementored trial using on-screen annotation and two-way audio, and an additional non-telementored trial. Simulation metrics of time (T), tip trajectory (TT), excessive traction (ET), and clipping errors (CE) were recorded. Independent scoring of the VR procedures using the validated Global Assessment of Laparoscopic Skills (GOALS) tool measured depth perception, bimanual dexterity, efficiency, tissue handling, autonomy, and level of difficulty.
Results: Performance between both groups in baseline trials was similar. Differences in clipping errors were significantly improved over baseline with post-intervention trials in the telementored versus non-telementored groups.
Conclusion: Telementoring may effectively micromanage technical maneuvers during resident training in the simulation environment. This study demonstrates that a single telementored procedure positively impacts proficiency.
Program Number: P156