Video self-assessment augments development of videoscopic suturing skill.
BACKGROUND
Development of surgical skills on inanimate models has been popularized by efforts to improve patient safety and efficiency of resident training. We evaluated whether surgical residents' acquisition of videoscopic suturing skill is accelerated by reviewing video of their own previous practice session.


METHODS
Fourteen residents from two general surgery training programs received didactic instruction on laparoscopy. Attempts at suturing and knotting were then timed and recorded for each subject, and half of them were provided a video of their attempts to review. After 7 to 10 days, repeat attempts were timed and recorded. Knots were mechanically tested, and videos were reviewed in blinded fashion.


RESULTS
Baseline characteristics were similar between the two groups. Both groups demonstrated improvement of videoscopic suturing efficiency and quality. On a 27-point scale, suturing and knot quality scores improved by an average of 11.6 (SD 3.9) in the video review group and 2.3 (SD 6.0) in the control group (p = 0.007). Times to complete the tasks were reduced by 30.3% (SD 11%) in the video review group and 3.1% (SD 32%) in the control group (p = 0.075). Eighty-six percent of video review subjects found the videos useful, and 86% of control subjects believed that videos would have been useful.


CONCLUSIONS
Development of videoscopic suturing skill is augmented by independent review of earlier attempts. Knot quality and technique are improved, with a trend toward increased speed. This minimal-cost method of enhancing skill training for junior residents parallels the effectiveness of video review in fields such as aviation and athletics.
Department of Surgery, University of California San Francisco, 513 Parnassus Ave, S-321, San Francisco, CA 94118, USA.
Ramin
R
Jamshidi
Teresa
T
LaMasters
Dan
D
Eisenberg
Quan-Yang
QY
Duh
Myriam
M
Curet
D000328:Adult; D000714:Anastomosis, Surgical; D001696:Biomechanical Phenomena; D002140:California; D002983:Clinical Competence; D003162:Competency-Based Education; D003194:Computer-Assisted Instruction; D015986:Confounding Factors, Epidemiologic; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010535:Laparoscopy; D009048:Motor Skills; D011597:Psychomotor Performance; D012107:Research Design; D013536:Suture Techniques / Q000193:education* / Q000592:standards; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods; D013997:Time Factors; D014741:Video Recording