Rural Surgeons Would Embrace Surgical Telementoring for Help with Difficult Cases and Acquisition of New Skills

Ian C Glenn, MD1, Danial Hayek1, Nicholas E Bruns, MD1, Tyler G Hughes, MD, FACS2, Todd A Ponsky, MD, FACS1. 1Akron Children’s Hospital, Akron, OH, 2McPherson Hospital, McPherson, KS

Introduction: The objective of this study was to apprise the attitudes of rural general surgeons toward the possible benefits and applications of surgical telementoring in their practices. Surgical telementoring, consisting of an expert surgeon guiding a less experienced surgeon through advanced or novel cases from a remote location, is an evolving technology which has potential to become an integral part of surgical practice. Despite numerous, previous proof of concept publications on the subject, there has been significant debate regarding truly feasible applications. The rural surgical environment has been suggested as a feasible environment. This study asks the question, "Will rural surgeons use telementoring if it were available, and how?"

Methods and Procedures: A link to a webpage with a description of this study and surgical telementoring, brief demonstrative video, and short survey assessing demographics and attitudes toward telementoring was emailed to members of the American College of Surgeons (ACS) Advisory Council for Rural Surgery. The link was additionally posted to the ACS website in areas specifically targeting rural surgeons.

Results: There were 159 total respondents, with 82.3% of them practicing in communities smaller than 50,000 people. Among all respondents, 78.6% felt that telementoring would be useful to their practice. Using a Fisher’s exact test, there was no correlation between years of practice and perceived usefulness of surgical telementoring. When asked what would be the single most useful, or primary, application of surgical telementoring, there was a split between learning new techniques (46.5%) and intraoperative assistance with unexpected findings (39.0%). Those surveyed were also asked to select all possible applications for surgical telementoring among a variety of choices. Intraoperative consultation for unexpected findings was chosen by 67.7%. Finally, 69.8% of those surveyed felt that surgical telementoring would be useful to their hospitals, but there were a diversity of opinions regarding payment for the service.

Conclusions: Surgical telementoring is still in its infancy but the results of this study show a strong interest in this technology among rural surgeons. Of note, the perceived usefulness of surgical telementoring is independent of experience, as measured by number of years in practice.  While there are differing opinions regarding compensation of the telementor, rural surgeons would embrace surgical telementoring for intraoperative consultation due to unexpected findings and for the acquisition of new skills.

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