Aliasger Amin, Mr1, Vivienne I Blackhall, Miss1, Kenneth G Walker, Professor1, Iya Whiteley, Dr2, Phillip Wilson, Professor3. 1Highland Academic Surgical Institute, 2Centre for Space Medicine at Mullard Space Science Laboratory, 3Centre for Rural Health, Aberdeen University
Introduction: As doctors become expert in a complex procedure, they develop automatic nuances of performance that are difficult to explain to a peer or a trainee (so called ‘unconscious competence’). Traditional methods which aim to allow sharing of expertise have limitations: concurrent reporting alters the flow of the task at hand while retrospective reporting is subject to bias and often incomplete. iView Expert is a technique validated in the aerospace domain which externalises an expert’s cognitive processes, without disrupting the task at hand.
The aim of this project is to assess the feasibility of adapting the technique to medical training.
Methods: This was an observational case study in which an expert endoscopist wore a head mounted camera to capture a complex procedure (colonoscopy). Captured video was reviewed during a facilitated debrief which externalised the expert’s cognitive processes. The debrief was recorded and formed an audio commentary. The video and accompanying audio commentary formed a learning package which was watched by a specialty trainee.
The technique differs from standard procedural videos in that it provides a more detailed insight into cognitive processes of the expert. This is achieved through the debrief, which encourages reflection upon kinaesthetic (head movement) as well as auditory and visual cues, resulting in a higher level of experiential immersion.
Questionnaires examined acceptability and educational value of the technique using Likert scales and free text answers. Quantitative data were presented using basic descriptions in terms of agreement with statements. Qualitative data from free text responses were coded in order to identify key themes.
Results: The expert agreed that wearing the camera was acceptable and did not interfere with the procedure, nor usual decision making processes.
Qualitative analysis revealed the debrief process to be associated with a high level of experiential immersion: “as if they were there”.
Both the expert and the trainee strongly agreed that the process was educationally valuable and that they learned something new.
Qualitative analysis demonstrated that the technique revealed useful and unique nuances of the procedure.
Conclusion: The intervention could represent a powerful adjunct to existing training methods, especially amongst more experienced practitioners. We are currently undertaking a larger study involving a greater range of procedures with more learners.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85114
Program Number: P344
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster