First submitted by:
Shawn Tsuda
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Telecommunication allows interaction over distances to overcome logistical constraints. In medicine and surgery, high band-width technology has allowed impressive feats of long-distance mentoring, proctoring, consultation, and remote procedures. Feasibility has been shown in controlling robotic arms or providing consultation between continents, between ship and land, and between air and land. However, the exact role of telecommunication in everyday medical practice is unclear.

Providing expert consultation where none is available is a clear application of telemedicine. However, as minimally invasive surgical techniques rapidly grow, trainee work hours shorten, and demand for quality patient care heightens, a greater role for telesurgery, teleproctoring, and telementoring will come to the forefront.


Teleproctoring refers to the supervision of a examination from a distance using telecommunication technology, whereas telementoring is remote guidance or teaching. Studies have shown how high band-width wireless technology allows bidirectional visual and audio communication with minimal loss to a recipient’s ability to absorb key information. The technology itself may not be the limiting factor in implementing telementoring. Rather, special challenges of teaching and learning without hands-on interaction or non-verbal human cues, and the ethical issues surrounding adequate supervision in patient care, need to be addressed.

The simulation and skills environment provides a method of testing and executing teleproctoring and telementoring. Students of all levels may learn though high-fidelity simulations or task-trainers while proctored by regional experts or busy staff who are physically unavailable but have access to communication media. Mentoring tasks and procedures in the real-world raises ethical questions of patient safety. The virtual reality environment provides a method to study and practice interactions that require audio-visual communication, telestration, and contingencies for technical failure.

A simulation and skills training center should have a level of telecommunication technology as part of its armament. Off-the-shelf media have impressive ability to provide video and audio interaction, recording, and broadcast ability. Ultimately, telementoring may provide a shortened pathway to gaining autonomous proficiency through a unique learning methodology.

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