The impact of objective assessment and constructive feedback on improvement of laparoscopic performance in the operating room.
OBJECTIVE
The study was carried out to demonstrate the impact of assessment and constructive feedback on improvement of laparoscopic performance in the operating room (OR).


METHODS
Sixteen surgical trainees performed a laparoscopic cholecystectomy in the OR. The participants were then divided into two groups. The procedure performed by group 1 was assessed by an experienced surgeon, and detailed and constructive feedback was provided to each trainee. Group 2 received no feedback. Subsequently, all subjects performed a new laparoscopic cholecystectomy in the OR. Both operative procedures were recorded on videotapes and assessed by two independent and blinded observers using a validated scoring system.


METHODS
Error and economy of movements score assessed during the laparoscopic procedures in the OR.


RESULTS
No differences in baseline assessments were found between the two groups (t-test, p > 0.5). Surgeons, who received feedback (group 1) made significantly greater improvement in their time to complete the following procedure (independent sample t-test, p = 0.022), error (t-test, p = 0.003) and economy of movement scores (t-test, p < 0.001).


CONCLUSIONS
Surgeons who received constructive feedback made significantly greater improvement in their performance in the OR compared with those in the control group. The study provides objective evidence that assessment is beneficial for surgical training and should be implemented in the educational programmes in the future.
Grantcharov
Teodor P
TP
Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Canada. t.grantcharov@gmail.com
Schulze
Svend
S
Kristiansen
Viggo B
VB
D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D030141:Feedback, Psychological; D006801:Humans; D009873:Operating Rooms; D013997:Time Factors; D014743:Videotape Recording