title: The learning effect of intraoperative video-enhanced surgical procedure training.
abstract: BACKGROUND
  The transition from basic skills training in a skills lab to procedure training in the operating theater using the traditional master-apprentice model (MAM) lacks uniformity and efficiency. When the supervising surgeon performs parts of a procedure, training opportunities are lost. To minimize this intervention by the supervisor and maximize the actual operating time for the trainee, we created a new training method called INtraoperative Video-Enhanced Surgical Training (INVEST).
  
  
  METHODS
  Ten surgical residents were trained in laparoscopic cholecystectomy either by the MAM or with INVEST. Each trainee performed six cholecystectomies that were objectively evaluated on an Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Absolute and relative improvements during the training curriculum were compared between the groups. A questionnaire evaluated the trainee's opinion on this new training method.
  
  
  RESULTS
  Skill improvement on the OSATS global rating scale was significantly greater for the trainees in the INVEST curriculum compared to the MAM, with mean absolute improvement 32.6 versus 14.0 points and mean relative improvement 59.1 versus 34.6% (P=0.02).
  
  
  CONCLUSIONS
  INVEST significantly enhances technical and procedural skill development during the early learning curve for laparoscopic cholecystectomy. Trainees were positive about the content and the idea of the curriculum.
authors.affiliation: Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands. mjvandet@gmail.com
authors.forename: M J
authors.initials: MJ
authors.lastname: van Det
authors.forename: W J H J
authors.initials: WJ
authors.lastname: Meijerink
authors.forename: C
authors.initials: C
authors.lastname: Hoff
authors.forename: L J
authors.initials: LJ
authors.lastname: Middel
authors.forename: S A
authors.initials: SA
authors.lastname: Koopal
authors.forename: J P E N
authors.initials: JP
authors.lastname: Pierie
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D059032:Learning Curve; D009426:Netherlands; D018579:Patient Selection; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D020775:Thoracic Surgery, Video-Assisted / Q000193:education*