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Efficacy of a new video-based training model in spinal surgery.

Heiland DH, Petridis AK, Maslehaty H, Thissen J, Kinzel A, Scholz M, Schreiber L - Surg Neurol Int (2014)

Bottom Line: Various biases that influence the learning success are under examination.Video-based training can improve microsurgical skills, leading to an improved learning curve.Because of the positive effect, we plan to apply the video-based training model to other neurosurgical subspecialties, especially neurovascular and skull base surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.

ABSTRACT

Background: An important part of neurosurgical training is the improvement of surgical skills. Acquiring microsurgical skills follows a learning curve, influenced by specific exercises, feedback, and training. Aim of training should be rapid learning success. The study shows the way in which video-based training can influence the learning curve.

Methods: Over a period of 18 months (2011-2012) 12 residents were evaluated in spinal surgery (12 cases per resident) by a skilled evaluator based on different criteria. The evaluation criteria (exposition of important anatomy, intraoperative bleeding, efficacy of using bipolar cauterization) were weighted and added to a single quality-score. The participating residents were divided into two groups. Only one group (n = 5) received video-based training.

Results: Residents showed an individually different but explicit increase in microsurgical skills. The quality-score during the first surgery compared with the end point of the study demonstrated a faster improvement of surgical skills in the group with video-based training than in the group without special training. Considering all residents together, the video-training group displayed a steeper gradient of microsurgical success. Comparison of the single resident's microsurgical skills showed individual disparities. Various biases that influence the learning success are under examination.

Conclusion: Video-based training can improve microsurgical skills, leading to an improved learning curve. An earlier entry of the learning curve plateau in the video-training group promotes a higher acquisition of surgical skills. Because of the positive effect, we plan to apply the video-based training model to other neurosurgical subspecialties, especially neurovascular and skull base surgery.

No MeSH data available.


Related in: MedlinePlus

(a) The learning curve of the video-based training group (VbG) and the control group (cG). The values shown were the mean quality score of all members in one surgical intervention of one group. The learning curve of the video-based group revealed a faster increase of the surgical skills after the sixth surgery and an earlier entry of the learning plateau. (b) The diagram presents the different mean gradients of the regression analysis. The video-based training group presents a significantly (P= 0.02) steeper gradient of their learning success between the beginning point and the seventh surgical interventions. (c) All linear regression curves are shown
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Figure 3: (a) The learning curve of the video-based training group (VbG) and the control group (cG). The values shown were the mean quality score of all members in one surgical intervention of one group. The learning curve of the video-based group revealed a faster increase of the surgical skills after the sixth surgery and an earlier entry of the learning plateau. (b) The diagram presents the different mean gradients of the regression analysis. The video-based training group presents a significantly (P= 0.02) steeper gradient of their learning success between the beginning point and the seventh surgical interventions. (c) All linear regression curves are shown

Mentions: The VbG revealed more improvement of the QS. For the learning curve, we compared the arithmetic mean of each group and surgery to work against individual differences. This value for each group is presented in Figure 3a. Both groups showed clear improvement in their surgical skills [Figure 3a]. Our first aim was to analyze the starting time point of the study. Both groups started with a similar skill level. This acted as a control for the randomized distribution of both groups and revealed an equal initial skill level. After the sixth surgery the groups started to increase their skill level in a different way. The VbG was able to improve their skills faster than the control group. After the eleventh surgery both groups exhibited similar skill levels. Between the first and sixth surgery a regression analysis [Figure 3b and c] revealed a significant difference between the VbG and the cG. The gradient of a linear regression curve between the first and seventh surgery was used for the student's t-test and reveals a significantly difference (P = 0.02) between both groups. This difference could be seen in Figure 3b, which shows the average gradient of both groups. The strongest effect of the video-based training could be seen at the beginning of the learning process but the improvement was truncated after 12-14 surgeries.


Efficacy of a new video-based training model in spinal surgery.

Heiland DH, Petridis AK, Maslehaty H, Thissen J, Kinzel A, Scholz M, Schreiber L - Surg Neurol Int (2014)

(a) The learning curve of the video-based training group (VbG) and the control group (cG). The values shown were the mean quality score of all members in one surgical intervention of one group. The learning curve of the video-based group revealed a faster increase of the surgical skills after the sixth surgery and an earlier entry of the learning plateau. (b) The diagram presents the different mean gradients of the regression analysis. The video-based training group presents a significantly (P= 0.02) steeper gradient of their learning success between the beginning point and the seventh surgical interventions. (c) All linear regression curves are shown
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927092&req=5

Figure 3: (a) The learning curve of the video-based training group (VbG) and the control group (cG). The values shown were the mean quality score of all members in one surgical intervention of one group. The learning curve of the video-based group revealed a faster increase of the surgical skills after the sixth surgery and an earlier entry of the learning plateau. (b) The diagram presents the different mean gradients of the regression analysis. The video-based training group presents a significantly (P= 0.02) steeper gradient of their learning success between the beginning point and the seventh surgical interventions. (c) All linear regression curves are shown
Mentions: The VbG revealed more improvement of the QS. For the learning curve, we compared the arithmetic mean of each group and surgery to work against individual differences. This value for each group is presented in Figure 3a. Both groups showed clear improvement in their surgical skills [Figure 3a]. Our first aim was to analyze the starting time point of the study. Both groups started with a similar skill level. This acted as a control for the randomized distribution of both groups and revealed an equal initial skill level. After the sixth surgery the groups started to increase their skill level in a different way. The VbG was able to improve their skills faster than the control group. After the eleventh surgery both groups exhibited similar skill levels. Between the first and sixth surgery a regression analysis [Figure 3b and c] revealed a significant difference between the VbG and the cG. The gradient of a linear regression curve between the first and seventh surgery was used for the student's t-test and reveals a significantly difference (P = 0.02) between both groups. This difference could be seen in Figure 3b, which shows the average gradient of both groups. The strongest effect of the video-based training could be seen at the beginning of the learning process but the improvement was truncated after 12-14 surgeries.

Bottom Line: Various biases that influence the learning success are under examination.Video-based training can improve microsurgical skills, leading to an improved learning curve.Because of the positive effect, we plan to apply the video-based training model to other neurosurgical subspecialties, especially neurovascular and skull base surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Klinikum Duisburg, Academic Teaching Hospital of The University Duisburg-Essen, Germany.

ABSTRACT

Background: An important part of neurosurgical training is the improvement of surgical skills. Acquiring microsurgical skills follows a learning curve, influenced by specific exercises, feedback, and training. Aim of training should be rapid learning success. The study shows the way in which video-based training can influence the learning curve.

Methods: Over a period of 18 months (2011-2012) 12 residents were evaluated in spinal surgery (12 cases per resident) by a skilled evaluator based on different criteria. The evaluation criteria (exposition of important anatomy, intraoperative bleeding, efficacy of using bipolar cauterization) were weighted and added to a single quality-score. The participating residents were divided into two groups. Only one group (n = 5) received video-based training.

Results: Residents showed an individually different but explicit increase in microsurgical skills. The quality-score during the first surgery compared with the end point of the study demonstrated a faster improvement of surgical skills in the group with video-based training than in the group without special training. Considering all residents together, the video-training group displayed a steeper gradient of microsurgical success. Comparison of the single resident's microsurgical skills showed individual disparities. Various biases that influence the learning success are under examination.

Conclusion: Video-based training can improve microsurgical skills, leading to an improved learning curve. An earlier entry of the learning curve plateau in the video-training group promotes a higher acquisition of surgical skills. Because of the positive effect, we plan to apply the video-based training model to other neurosurgical subspecialties, especially neurovascular and skull base surgery.

No MeSH data available.


Related in: MedlinePlus