Video-based microlearning improves vascular surgery resident proficiency in end-to-side anastomosis

Abstract

Objective: Effective and comprehensive surgical training poses a challenge for residency programs. Considering patient safety and limited work hours, training must be a time-efficient and effective use of simulation before practicing in the operating room. Therefore, we have integrated video-based microlearning for our surgical residents, focusing on end-to-side anastomosis techniques. By having three senior surgeons evaluate resident performance and give feedback to trainees, we aimed to validate the effectiveness of this educational approach.

Methods: Surgical residents were initially instructed to perform end-to-side anastomosis using a Penrose (simulating an artery) and 6-0 Prolene with minimal input. Subsequently, they were asked to review an 11-step procedure document and 10 video-based microlearning modules for end-to-side anastomosis techniques before performing their next anastomosis. Three senior vascular surgeons assessed the residents' practical skills. They provided feedback and assigned scores out of 17 based on the 8-item procedural checklist, including bite spacing, eversion, heel-toe evaluation, total time, back-walling, posterior wall cut, and several possible leaks.

Results: Trainee samples (n = 18 pairs) were continually graded and recorded. Feedback received from the participants highlighted the effectiveness of video-based microlearning. Paired t tests were conducted on participant samples, which showed an overall significant improvement in scores (P < .05) graded by the surgeons. The mean change in pretest vs post-test scores was 3.0 to 6.1 for surgeon 1, 3.6 to 7.4 for surgeon 2, and 7.6 to 9.6 for surgeon 3. The intraclass correlation coefficient for surgeon agreement was 0.93 to 1.00, indicating high reliability.

Conclusions: Our study aimed to highlight the feasibility of video-based microlearning as a valuable adjunct to traditional vascular surgery residency training. As surgical training continues to evolve, such innovative learning approaches promise to optimize surgical education and ultimately improve patient outcomes in vascular surgery. Further research is warranted to explore the long-term impacts and scalability across residency programs.

Keywords: Anastomosis; Microlearning; Simulation; Surgical education; Vascular training.

Fig 1

Box plot depicting scores of paired samples as evaluated by the respective surgeons.

Fig 2

Side view of ideal sample of end-to-side anastomosis.

Fig 3

Heel view of ideal sample of end-to-side anastomosis.

Fig 4

End-to-side anastomosis sample showcasing errors of inversion, eversion, and uneven bites.

Fig 5

End-to-side anastomosis sample showcasing back-walling error.