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Educational implications for surgical telementoring: a current review with recommendations for future practice, policy, and research

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Abstract

Background

Surgical telementoring (ST) was introduced in the sixties, promoting videoconferencing to enhance surgical education across large distances. Widespread use of ST in the surgical community is lacking. Despite numerous surveys assessing ST, there remains a lack of high-level scientific evidence demonstrating its impact on mentorship and surgical education. Despite this, there is an ongoing paradigm shift involving remote presence technologies and their application to skill development and technique dissemination in the international surgical community. Factors facilitating this include improved access to ST technology, including ease of use and data transmission, and affordability. Several international research initiatives have commenced to strengthen the scientific foundation documenting the impact of ST in surgical education and performance.

Methods

International experts on ST were invited to the SAGES Project Six Summit in August 2015. Two experts in surgical education prepared relevant questions for discussion and organized the meeting (JP and HH). The questions were open-ended, and the discussion continued until no new item appeared. The transcripts of interviews were recorded by a secretary from SAGES.

Results

In this paper, we present a summary of the work performed by the SAGES Project 6 Education Working Group. We summarize the existing evidence regarding education in ST, identify and detail conceptual educational frameworks that may be used during ST, and present a structured framework for an educational curriculum in ST.

Conclusions

The educational impact and optimal curricular organization of ST programs are largely unexplored. We outline the critical components of a structured ST curriculum, including prerequisites, teaching modalities, and key curricular components. We also detail research strategies critical to its continued evolution as an educational tool, including randomized controlled trials, establishment of a quality registry, qualitative research, learning analytics, and development of a standardized taxonomy.

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References

  1. Soper NJ (2001) SAGES and surgical education. Surg Endosc 15(8):775–780

    Article  CAS  PubMed  Google Scholar 

  2. Cooke M, Irby DM, Sullivan W, Ludmerer K (2006) American medical education 100 years after the Flexner report. N Engl J Med 14(355):1339–1344

    Article  Google Scholar 

  3. Kim S, Dunkin BJ, Paige JT, Eggerstedt JM, Nicholas C, Vassilliou MC et al (2014) What is the future of training in surgery? Needs assessment of national stakeholders. Surgery. 156(3):707–717

    Article  PubMed  Google Scholar 

  4. Claydon E, McAlister VC (2012) The life of John Wishart (1850–1926): study of an academic surgical career prior to the flexner report. World J Surg 36(3):684–688

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bilimoria K, Hoyt D, Lewis F (2015) Making the case for investigating flexibility in duty hour limits for surgical residents. JAMA Surg 150(6):503–504

    Article  PubMed  Google Scholar 

  6. Sheldon GF (2007) Surgical workforce since the 1975 study of surgical services in the United States: an update. Ann Surg 246(4):541–545

    Article  PubMed  Google Scholar 

  7. Fraher E, Knapton A, Sheldon G, Meyer A, Ricketts TC (2013) Projecting surgeon supply using a dynamic model. Ann Surg 257(5):867–872

    Article  PubMed  Google Scholar 

  8. Williams TE Jr, Satiani B, Thomas A, Ellison EC (2009) The impending shortage and the estimated cost of training the future surgical workforce. Ann Surg 250(4):590–597

    PubMed  Google Scholar 

  9. Ponsky T, Schwachter M, Parry J, Rothenberg S, Augestad K (2014) Telementoring: the surgical tool of the future. Eur J Pediatr Surg 24(04):287–294

    Article  PubMed  Google Scholar 

  10. Augestad KM, Bogen E, Patel H (2014) Telemedicine as a quality improvement facilitator in pelvic cancer surgery. In: Patel H, Delaney CP (eds) Pelvic cancer surgery. Springer, London, pp 29–37

    Google Scholar 

  11. Wood D (2011) No surgeon should operate alone: how telementoring could change operations. Telemed e-Health 17(3):150–152

    Article  Google Scholar 

  12. Doarn CR (2003) Telemedicine in tomorrow’s operating room: a natural fit. Surg Innov 10(3):121–126

    Article  Google Scholar 

  13. Augestad KM, Lindsetmo RO (2009) Overcoming distance: video-conferencing as a clinical and educational tool among surgeons. World J Surg 33(7):1356–1365

    Article  PubMed  PubMed Central  Google Scholar 

  14. Gambadauro P, Magos A (2008) NEST (network enhanced surgical training): a PC-based system for telementoring in gynaecological surgery. Eur J Obstet Gynecol Reprod Biol 139(2):222–225

    Article  PubMed  Google Scholar 

  15. Schlachta C, Kent S, Lefebvre K, McCune M, Jayaraman S (2008) A model for longitudinal mentoring and telementoring of laparoscopic colon surgery. Surg Endosc 23(7):1634–1638

    Article  PubMed  Google Scholar 

  16. Schlachta C, Lefebvre K, Sorsdahl A, Jayaraman S (2009) Mentoring and telementoring leads to effective incorporation of laparoscopic colon surgery. Surg Endosc 24(4):841–844

    Article  PubMed  Google Scholar 

  17. Rothenberg S, Yoder S, Kay S, Ponsky T (2011) Initial experience with surgical telementoring in pediatric laparoscopic surgery using remote presence technology. J Laparoendosc Adv Surg Tech 5:1–4

    Google Scholar 

  18. Netto NR, Mitre AI, Lima SVC, Fugita OE, Lima ML, Stoianovici D et al (2003) Telementoring between Brazil and the United States: initial experience. J Endourol 17(4):217–220

    Article  Google Scholar 

  19. Baram-Clothier E, Augestad KM (2014) Surgical telementoring news. The American Medical Foundation Newsletter [Internet]. 7(1):1–10. http://www.medicalfoundation.org/wp-content/uploads/2012/04/Surgical-Telementoring-News-2014e.pdf

  20. Rosser JC, Gabriel N, Herman BAB, Murayama M (2001) Telementoring and Teleproctoring. World J Surg 25(11):1438–1448

    Article  PubMed  Google Scholar 

  21. SAGES (2004) Guidelines for the surgical practice of telemedicine. 26:1–10. https://www.sages.org/publications/guidelines/guidelines-for-the-surgical-practice-of-telemedicine/

  22. Schlachta CM, Nguyen NT, Ponsky T, Dunkin B (2016) Project 6 Summit: SAGES telementoring initiative. Surg Endosc 25:1–8

    Google Scholar 

  23. SAGES (2013) Framework for post-residency surgical education & training. 26:1–9. http://www.sages.org/publications/guidelines/framework-for-post-residency-surgical-education-training/

  24. Budrionis A, Hasvold P, Hartvigsen G, Bellika JG (2016) Assessing the impact of telestration on surgical telementoring: A randomized controlled trial. J Telemed Telecare 22(1):12–17

    Article  PubMed  Google Scholar 

  25. Budronius A, Belika JG, Augestad K (2012) Telestration in mobile telementoring. eTELEMED 2013: the fifth international conference on eHealth, telemedicine, and social medicine. ISBN: 978-1-61208-252-3:1–3

  26. Augestad K (2013) Surgical telementoring in knowledge translation—clinical outcomes and educational benefits: a comprehensive review. Surg Innov 20(3):276–284

    Article  Google Scholar 

  27. Byrne JP, Mughal MM (2000) Telementoring as an adjunct to training and competence-based assessment in laparoscopic cholecystectomy. Surg Endosc 14(12):1159–1161

    Article  CAS  PubMed  Google Scholar 

  28. Ereso AQ, Garcia P, Tseng E, Gauger G, Kim H, Dua MM, et al (2010) Live transference of surgical subspecialty skills using telerobotic proctoring to remote general surgeons. ACS 211(3):400–411

  29. Valentino MD (2005) Telementoring during endovascular treatment of abdominal aortic aneurysms. J Endovasc Ther [Internet]. 16(12):200–205

    Article  Google Scholar 

  30. Snyder CW, Vandromme MJ, Tyra SL, Hawn MT (2012) Proficiency-based laparoscopic and endoscopic training with virtual reality simulators: a comparison of proctored and independent approaches. JSURG 66(4):201–207

    Google Scholar 

  31. Panait L, Rafiq A, Tomulescu V, Boanca C, Popescu I, Carbonell A et al (2005) Telementoring versus on-site mentoring in virtual reality-based surgical training. Surg Endosc 20(1):113–118

    Article  PubMed  Google Scholar 

  32. Rafiq A, Moore JA, Zhao X, Doarn CR, Merrell RC (2004) Digital video capture and synchronous consultation in open surgery. Ann Surg 239(4):567–573

    Article  PubMed  PubMed Central  Google Scholar 

  33. Sereno S, Mutter D, Dallemagne B, Smith CD, Marescaux J (2007) Telementoring for minimally invasive surgical training by wireless robot. Surg Innov 14(3):184–191

    Article  CAS  PubMed  Google Scholar 

  34. Greenberg CC, Dombrowski J, Dimick JB (2015) Video-based surgical coaching. JAMA Surg 151(3):282

    Article  Google Scholar 

  35. Singh P, Aggarwal R, Tahir M, Pucher PH, Darzi A (2015) A randomized controlled study to evaluate the role of video-based coaching in training laparoscopic skills. Ann Surg 261(5):862–869

    Article  PubMed  Google Scholar 

  36. Cole SJ, Mackenzie H, Ha J, Hanna GB, Miskovic D (2014) Randomized controlled trial on the effect of coaching in simulated laparoscopic training. Surg Endosc 28(3):979–986

    Article  PubMed  Google Scholar 

  37. Karam MD, Thomas GW, Koehler DM, Westerlind BO, Lafferty PM, Ohrt GT et al (2015) Surgical coaching from head-mounted video in the training of fluoroscopically guided articular fracture surgery. J Bone Joint Surg Am 97(12):1031–1039

    Article  PubMed  Google Scholar 

  38. Birkmeyer JD, Finks JF, O’Reilly A, Oerline M, Carlin AM, Nunn AR et al (2013) Surgical skill and complication rates after bariatric surgery. N Engl J Med 369(15):1434–1442

    Article  CAS  PubMed  Google Scholar 

  39. Vassiliou M, Feldman L, Andrew C, Bergman S, Leffondré K, Stanbridge D et al (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. AJS 190(1):7

    Google Scholar 

  40. Martin J, Regehr G, Reznick RK, Macrae H, Murnaghan J, Hutchinson C et al (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84(2):273–278

    Article  CAS  PubMed  Google Scholar 

  41. Larson L, Williams R, Ketchum J, Boehler M, Dunnington G (2005) Feasibility, reliability and validity of an operative performance rating system for evaluating surgery residents. Surgery 138(4):640–649

    Article  PubMed  Google Scholar 

  42. Budrionis A, Augestad KM, Patel HR, Bellika JG (2013) An evaluation framework for defining the contributions of telestration in surgical telementoring. Interact J Med Res 2(2):e14

    Article  PubMed  PubMed Central  Google Scholar 

  43. Bandura A (1977) Social learning theory. Prentice Hall, Toronto

    Google Scholar 

  44. Lave J, Wenger E (1991) Situated learning. Cambridge University Press, Cambridge

    Book  Google Scholar 

  45. Dubé L, Bourhis A, Jacob R (2005) The impact of structuring characteristics on the launching of virtual communities of practice. J Org Change Mgmt 18(2):145–166

    Article  Google Scholar 

  46. More MG (1997) In: Keegan D (ed) Theory of transactional distance. Routledge, Abingdon

  47. Branch RM (2009) Instructional design: the ADDIE approach. Springer Science & Business Media, Berlin

    Book  Google Scholar 

  48. Asad E, Hassan RB, Sherwani EF (2014) Instructional models for enhancing the performance of students and workforce during educational training. Academ Arena 6(3):27–31

    Google Scholar 

  49. Singh P, Aggarwal R, Tahir M, Pucher PH, Darzi A (2015) A randomized controlled study to evaluate the role of video-based coaching in training laparoscopic skills. Ann Surg 261(5):862–869

    Article  PubMed  Google Scholar 

  50. Wyles S, Miskovic D, Ni Z, Darzi A, Valori R, Coleman M, et al (2016) Development and implementation of the Structured Training Trainer Assessment Report (STTAR) in the English National Training Programme for laparoscopic colorectal surgery. Surg Endosc 30(3):993–1003

    Article  PubMed  Google Scholar 

  51. Vincent C, Moorthy K, Sarker S, Chang A, Darzi A (2004) Systems approaches to surgical quality and safety. Ann Surg 239(4):475–482

    Article  PubMed  PubMed Central  Google Scholar 

  52. Warth L, Bogen E, Lindsetmo RO, Patel H, Augestad KM (2015) Collaboration in surgical training. A qualitative study of mentoring laparoscopic surgeons by using videoconference in northern Norway. eTELEMED: the seventh international conference on eHealth, telemedicine, and social medicine. ISBN: 978-1-61208-384-1:6–9

  53. Warth L, Patel H, Bogen E, Gjessing P, Augestad KM, Ponsky T, et al (2015) Video-recorded observations of surgical telementoring. Int J Adv Life Sci 7:1–8. http://www.thinkmind.org/index.php?view=article&articleid=lifsci_v7_n34_2015_3

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Acknowledgements

Rolv-Ole Lindsetmo, MD, PhD; Michael Kim, MD; Melina Vassilou, MD; Erik Dutson, MD; Maria Marcela Bailez, MD; Rifat Latifi, MD. Industry participants: Chuck Kennedy (Medtronic), Brian Witte (Ethicon), Kris Danforth (Stryker), Suzanne Jefferson (Karl Storz), Anthony Jarc (Intuitive).

Disclosures

Dr. Paige discloses other support from Oxford University Press, as well as grants from LSU Board of Supervisors, Acell, Inc., Intuitive Inc., HRSA, and SGEA, during the conduct of the study; he also discloses that he serves as Chair of the Continuing Education Committee for SAGES. Dr. Ponsky discloses personal fees from Conmed, during the conduct of the study. Drs. Augestad, Han, Schlachta, Dunkin, and Mellinger have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery, Oslo University Hospital AHUS, Oslo, Norway

    K. M. Augestad

  2. Norwegian National Centre of Telemedicine, Tromsø, Norway

    K. M. Augestad

  3. Department of Medical Education, SIU School of Medicine, Springfield, IL, USA

    H. Han

  4. Department of Surgery, LSU Health New Orleans School of Medicine, New Orleans, USA

    J. Paige

  5. Department of Pediatric Surgery, Akron Childrens Hospital, Akron, OH, USA

    T. Ponsky

  6. Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada

    C. M. Schlachta

  7. Department of Surgery, Houston Methodist Hospital, Houston, TX, USA

    B. Dunkin

  8. Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA

    J. Mellinger

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  1. K. M. Augestad
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  2. H. Han
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  3. J. Paige
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  5. C. M. Schlachta
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  6. B. Dunkin
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  7. J. Mellinger
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Corresponding author

Correspondence to J. Mellinger.

Additional information

Surgical education is at a critical juncture today, threatened by diminished funding, competing service obligations, mounting paper work, and the need to do more in less time with less support. However, it is only by maintaining effective teaching and mentoring of surgical skills, concepts, and precepts that our profession will remain strong. NJ Soper; SAGES 2001 presidential address [1].

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Augestad, K.M., Han, H., Paige, J. et al. Educational implications for surgical telementoring: a current review with recommendations for future practice, policy, and research. Surg Endosc 31, 3836–3846 (2017). https://doi.org/10.1007/s00464-017-5690-y

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