Educational value of telementoring for a simulation-based fundamental use of surgical energy™ (FUSE) curriculum: a randomized controlled trial in surgical trainees.

Abstract

The SAGES Fundamental Use of Surgical Energy (FUSE) program accompanied by a bench-top simulation has shown to improve knowledge of the safe use of energy devices. However, there are significant barriers and costs associated with delivering an effective structured simulation curriculum to a widespread international audience. The purpose of this study was to evaluate if bench-top simulation FUSE curriculum through telementoring is as effective as a live-in house proctor for electrosurgical training. A two-armed multi-institutional randomized controlled trial was designed, including a 1-h didactic electrosurgery course (FUSE curriculum), followed by a structured 1-h bench-top simulation training session. For the simulation, participants were randomized to either a live proctor who delivered the course on-site (LIVE group), or a proctor from a remote location using videoconferencing platform (TELEM group). Pre- and post-curriculum (immediate and 6months) knowledge and self-perceived comfort and competence were assessed. Data are expressed as median [interquartile range], *p < 0.05. Sixty-five (35 LIVE; 30 TELEM) surgical trainees from three institutions participated. Baseline characteristics were similar. Total score on the exam improved from 47% [40-54] to 78% [71-84]* amongst all participants, with similar immediate post-curriculum scores in the LIVE group compared to the TELEM group (77% [69-83] vs 80% [75-85]). At 6 months, performance on the exam declined significantly for both groups, but remained similar between the two (LIVE: 59% [51-71] vs TELEM: 71% [57-77]). Participants in both groups reported feeling greater comfort and competence post-curriculum (immediate and at 6months) compared to baseline, with no difference between the two groups. A bench-top simulation FUSE course delivered via a telementoring platform seems to improve surgical trainees' knowledge and comfort in the safe use of electrosurgical devices as effectively as when it is delivered by a live proctor, despite long-term decay for both methods.