The impact of feedback on laparoscopic skills for surgical residents during COVID-19

ABSTRACT

Background: We sought to determine how real-time video feedback compares to delayed written feedback on junior resident performance of laparoscopic skills using at-home laparoscopic training boxes. Methods: Junior surgical residents from Memorial University were randomized into 3 groups a control group (group A), a delayed feedback group (group B), and a live feedback group (group C). Data collection was 5 months in duration. Participants practised prescribed laparoscopic skills biweekly. Intervention groups (B and C) received either delayed or live feedback on weekly practice from an expert. Pre- and post-testing were completed. Results: Twelve residents were recruited;1 was lost to follow-up. After the data collection period, the average number of pegs transferred correctly increased by 2.8 ± 1.7 for group A, 3.0 ± 2.6 for group B, and 2.0 ± 1.4 for group C. There was significant group variance (F2,8 = 5.928, p = 0.026). Post hoc testing resulted in group B outperforming groups A and C. For the intracorporeal knot tying task and number of throws completed, groups B and C both improved;no significant difference was noted between groups. Qualitative data showed an increase in confidence for all groups in completing the tasks and a preference for live compared with delayed feedback. Conclusion: Access to box trainers allowed residents to practise at home, leading to improved skill and confidence. Participants receiving delayed feedback showed a significant improvement in peg transfer. Further studies with larger sample sizes should be conducted on how feedback can affect resident outcomes in laparoscopic surgery skills.