Telestration in the Teaching of Basic Surgical Skills: A Randomized Trial

Abstract

To evaluate how an affordable course using telestration with augmented reality can be compared to the traditional teaching of basic surgical skills. Prospective, randomized and blinded study. Faculty of Medicine of PortoUniversity. Twenty medical students without any experience in basic surgical skills were randomized into two different learning groups: telestration and traditional teaching (on-site mentoring) groups. Five different types of sutures were taught: the single interrupted, the cruciate mattress, the horizontal mattress, the vertical mattress and the simple continuous sutures. Data was obtained on the time taken to learn each of the techniques and to perform each exercise without any support from the faculty, tension of the suture, quality of the procedure using a modified Objective Structured Assessment of Technical Skills and participants' answers to a Likert questionnaire in terms of their learning experience, confidence, and self-evaluation. Trainees in the telestration group were globally faster when performing independently (1393.40 [SD 288.89] vs 1679.00 [SD 328.22] seconds, p = 0.04) particularly during the cruciate mattress suture (235.50 [SD 61.81] vs 290.00 [SD 68.77] seconds, p = 0.05) and the simple continuous suture (492.40 [SD 87.49] vs 630.30 [SD 132.34] seconds, p = 0.01).Time needed for students to learn the procedures was similar between the groups. There were also no statistically significant differences in terms of the quality of the surgical gesture, tension of the suture, self-evaluation or confidence. A basic surgical skills course using telestration through a head-mounted device with augmented reality capabilities can be a viable alternative to traditional teaching, considering time and quality of the gesture. Though costs can discourage from using this technology in basic procedures, the use of free software may turn it into an affordable option in the context of distant learning.