title: Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training.
abstract: BACKGROUND
  INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST compared to MAM.
  
  
  METHODS
  Ten surgical residents with no laparoscopic experience were recruited for a laparoscopic cholecystectomy training curriculum either by the MAM or with INVEST. After a uniform course in basic laparoscopic skills, each trainee performed six cholecystectomies that were digitally recorded. For 14 steps of the procedure, an observer who was blinded for the type of training determined whether the step was performed entirely by the trainee (2 points), partially by the trainee (1 point), or by the supervisor (0 points). Time measurements revealed the total procedure time and the amount of effective procedure time during which the trainee acted as the operating surgeon. Results were compared between both groups.
  
  
  RESULTS
  Trainees in the INVEST group were awarded statistically significant more points (115.8 vs. 70.2; p < 0.001) and performed more steps without the interference of the supervisor (46.6 vs. 18.8; p < 0.001). Total procedure time was not lengthened by INVEST, and the part performed by trainees was significantly larger (69.9 vs. 54.1 %; p = 0.004).
  
  
  CONCLUSIONS
  INVEST enhances effectiveness and training efficiency for procedural training inside the operating theater without compromising operating theater time efficiency.
authors: Department of Surgery, Medical Center Leeuwarden, PO Box 888, 8901 BR, Leeuwarden, The Netherlands. mjvandet@gmail.com
authors: M J
authors: MJ
authors: van Det
authors: W J H J
authors: WJ
authors: Meijerink
authors: C
authors: C
authors: Hoff
authors: B
authors: B
authors: Middel
authors: J P E N
authors: JP
authors: Pierie
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007432:Intraoperative Period; D059032:Learning Curve; D009873:Operating Rooms; D015203:Reproducibility of Results; D014741:Video Recording