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. 2023 Jan 9:35:e1712.
doi: 10.1590/0102-672020220002e1712. eCollection 2023.

REMOTE ASYNCHRONOUS FEEDBACK FOR UNSUPERVISED LAPAROSCOPIC TRAINING: THE "LAPP" PLATFORM

Gabriel Ulloa  1 , Andres Neyem  1 , Gabriel Escalona  2 , Catalina Ortiz  2 , Julian Varas  2
Affiliations

REMOTE ASYNCHRONOUS FEEDBACK FOR UNSUPERVISED LAPAROSCOPIC TRAINING: THE "LAPP" PLATFORM

Gabriel Ulloa et al. Arq Bras Cir Dig. .

Abstract
in English, Portuguese

Background: The advantages of laparoscopic surgery over traditional open surgery have changed the surgical education paradigm in the past 20 years. Among its benefits are an improvement in clinical outcomes and patient safety, becoming the standard in many surgical procedures. However, it encompasses an additional challenge due to the complexity to achieve the desired competency level. Simulation-based training has emerged as a solution to this problem. However, there is a relative scarcity of experts to provide personalized feedback. Technology-Enhanced Learning could be a valuable aid in personalizing the learning process and overcoming geographic and time-related barriers that otherwise would preclude the training to happen. Currently, various educational digital platforms are available, but none of them is able to successfully provide personalized feedback.

Aims: The aim of this study was to develop and test a proof of concept of a novel Technology-Enhanced Learning laparoscopic skills platform with personalized remote feedback.

Methods: The platform "Lapp," a web and mobile cloud-based solution, is proposed. It consists of a web and mobile application where teachers can evaluate remotely and asynchronously exercises performed by students, adding personalized feedback for trainees to achieve a learning curve wherever and whenever they train. To assess the effectiveness of this platform, two groups of students were compared: 130 participants received in-person feedback and 39 participants received remote asynchronous feedback throughout the application.

Results: The results showed no significant differences regarding competency levels among both groups.

Conclusion: A novel Technology-Enhanced Learning strategy consisting of remote asynchronous feedback throughout Lapp facilitates and optimizes learning, solving traditional spatiotemporal limitations.

RACIONAL:: As vantagens da cirurgia laparoscópica sobre a cirurgia aberta tradicional mudaram o paradigma da educação cirúrgica nos últimos 20 anos, tornando-se o padrão em muitos procedimentos cirúrgicos. No entanto, envolve um desafio adicional devido à complexidade para atingir o nível de competência desejado. O treinamento baseado em simulação surgiu como uma solução. No entanto, há uma relativa escassez de especialistas para fornecer feedback personalizado. A Technology Enhanced Learning pode ser uma ajuda valiosa na personalização do processo de aprendizagem e na superação de barreiras geográficas e temporais que impediriam o treinamento. Atualmente, várias plataformas educacionais estão disponíveis, mas nenhuma delas é capaz de fornecer feedback personalizado.

OBJETIVOS:: desenvolver e testar uma prova de conceito de uma nova plataforma de habilidades laparoscópicas da Technology Enhanced Learning com feedback remoto personalizado.

MÉTODOS:: É proposta a plataforma “Lapp”, uma solução web e móvel baseada em nuvem. É composta por uma aplicação web em que os professores podem avaliar remotamente e de forma assíncrona exercícios realizados pelos alunos, adicionando feedback personalizado para os formandos alcançarem uma curva de aprendizagem onde e quando treinam. Para avaliar a eficácia desta plataforma, dois grupos de alunos foram comparados. 130 participantes receberam feedback pessoal e 39 participantes receberam feedback remoto assíncrono em todo o aplicativo.

RESULTADOS:: Os resultados não mostraram diferenças significativas em relação ao nível de competência entre os dois grupos.

CONCLUSÕES:: Uma nova estratégia Technology Enhanced Learning que consiste em feedback assíncrono remoto em toda a Lapp facilita e otimiza o aprendizado, resolvendo as limitações espaço-temporais tradicionais.

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Conflict of interest statement

Conflict of interest: Dr. Julián Varas is a cofounder of the company T&C, which manufactured the surgical simulators used in this study. The rest of the authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.

Figures

Figure 1.
Figure 1.. Sequence diagram showing the flow of communication between the different components of the platform.
Figure 2.
Figure 2.. General architecture for the proposed user-centered mobile cloud computing platform.
Figure 3.
Figure 3.. Mobile application. (a) Tutorial screen, where the students watch tutorial videos of the exercises to perform; (b) Evaluation screen, where the students watch the feedback provided by the teacher; (c) Evaluation screen, with a drawing over the image to mark a correction.
Figure 4.
Figure 4.. Web application. As shown in the screen, the teacher reviews an evaluation. Several audiovisual tools are available to facilitate the evaluation and provide multimodal feedback.
See this image and copyright information in PMC

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