The Anatomy of Meckel's Cave: A New Landmark for Innovative Surgical Approaches

Abstract

The American Board of Surgery encourages graduating medical students to prepare for surgical residency before day 1. We sought to determine the impact of personalized video feedback on an advance preparation task.We conducted a nonrandomized study comparing video feedback versus no feedback. We sent incoming surgical interns a preparatory package 2 months before starting residency. Trainees video-recorded themselves performing a subcuticular wound closure, 3 times at 3-week intervals, and submitted these for appraisal. A staff surgeon provided personalized feedback on each video as a narrated voiceover. The voiced-over videos were then returned to trainees. We compared performance (time and completion rate) on suturing in a multistation assessment against residents from the previous year (no-feedback group).The feedback group had a higher completion rate for the suturing assessment than the no-feedback group (23/28 [82%] vs. 8/27 [30%], P < .0001). The feedback group also completed the suturing station at a faster rate than those without feedback (hazard ratio 4.9 [95% confidence interval (CI): 2.2,11.2), P < .0001). Global rating scores were significantly higher for the feedback group (mean difference [5-point scale] = 0.7 [95% CI: 0.3, 1.1]). However, Objective Structured Assessment of Technical Skills scores indicated no significant difference between groups (mean difference [5-point scale] = 0.3 [95% CI: 0.0, 0.6]). Within the feedback group, we found significant improvement from baseline to final performances (mean difference = 109 seconds [95% CI: 79, 140]).Personalized narrated feedback as part of a home-based advance preparation package for incoming residents is associated with higher performance on early objective assessments.