Thomas M Cahir, Amlish Gondal, MD, David Biffar, Iman Ghaderi, MD, MSc. University of Arizona
Introduction: The Fundamentals of Laparoscopic Surgery (FLS) skills curriculum is an established simulation program with proven clinical value. Time constraint is one of the barriers for individualized training of surgical residents on FLS skills by faculty in busy clinical environments. The purpose of this study was to develop and implement a self-directed, proficiency-based technical skills training model with the use of cellphone cameras as a telementoring tool.
Methods and procedures: This curriculum was developed by the Arizona Center for Endoscopic Surgery (ACES) in collaboration with the Arizona Simulation Training & Education Center (ASTEC). A universally adjustable cellphone holder was used where smartphones could be placed inside the FLS box in order to capture the task from a similar angle as the onboard camera. Residents were able to use their own smartphones to record their performance on each of the five FLS tasks in high definition (HD) quality. After each practicing session, they would upload their videos to a designated folder on a password-protected computer in the simulation lab. This folder was linked to a cloud-based storage system that FLS instructor had exclusive access. The faculty was able to review each video in the next 24 hours and provide immediate feedback to the residents via email, over the phone or in-person. The video library of performance also allowed the instructor to track the progress of the residents and whether they reached proficiency level in all five tasks to take the FLS examination. This program was offered to all surgical trainees.
Results: Utilization of simulation lab to practice FLS tasks increased significantly across all postgraduate years after implementation of this model. Six residents took the FLS examination. The passing rate of the residents remained the same (100% before and after) but their scores in FLS manual skills improved significantly compared to the group prior to implementation. The residents evaluated this change positively and reported that the use of videos and immediate feedback by faculty was a valuable intervention in their learning experience.
Conclusions: The smartphone cameras are readily available and can be used for telementoring. Incorporation of telementoring in standard proficiency based FLS training can promote self-directed learning and improve the access to experts for immediate feedback as a crucial element of effective training in acquisition of laparoscopic skills.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88496
Program Number: P322
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster