Impact of Video Coaching on Gynecologic Resident Laparoscopic Suturing: A Randomized Controlled Trial

Abstract

Study objective: To determine if the addition of video coaching to an obstetrics and gynecology resident laparoscopic simulation curriculum improves acquisition of suturing skills.

Design: Randomized controlled trial (Canadian Task Force classification I).

Setting: Academic teaching hospital with a residency program in obstetrics and gynecology.

Patients: Twenty obstetrics and gynecology residents undergoing a 4-week laparoscopic simulation curriculum were video recorded weekly performing a suturing task on a validated vaginal cuff model.

Interventions: Residents were randomized to standard simulation curriculum or standard curriculum plus weekly video coaching by an expert laparoscopic surgeon. Primary outcome measure was comparison of weekly Global Operative Assessment of Laparoscopic Skills plus Vaginal Cuff Metrics (GOALS+) scores of the suturing task.

Measurements and main results: Baseline GOALS+ scores did not differ across training groups (p = .406), although "senior" (postgraduate years 3 and 4) residents initially had significantly higher GOALS+ scores than "junior" (postgraduate years 1 and 2) residents (p < .001). GOALS+ scores significantly improved from week 1 to week 2 in the intervention group compared with the control group (p < .05). Junior coached residents had significantly higher GOALS+ scores at week 2 (mean, 28.06; standard deviation, 3.10) compared with the junior control residents (mean, 20.75; standard deviation, 6.38; p < .04). Over the 4-week period all residents showed significant improvement (p = .005), with novice residents improving more than experienced residents (p = .001). The junior coached residents exhibited a significant difference between weeks 1 and 2 when compared with the junior residents undergoing the standard curriculum.

Conclusion: Video coaching during laparoscopic simulation training has the greatest impact early in junior learners' skill acquisition, thus providing another tool for simulation training curricula.

Keywords: Gynecology training; Laparoscopic suturing; Laparoscopic teaching; Resident education; Simulation; Surgery.