Sunday June 30, 2019 from 07:30 to 09:00
SMARTv: Surgical Mentoring by Annotated Real-Time Video
Anne-Sophie Blais1, Shaun Trecarten1, Ivan Reel1, Greg Patterson1, Armando J. Lorenzo1, Fadi Zu'bi1, Darius J. Bagli1.
1Urology, Hospital for Sick Children, Toronto, ON, Canada
Introduction: As surgical modalities expand and operative caseloads are reduced, new teaching strategies are needed to enhance intraoperative learning. We developed a novel intraoperative training strategy of Surgical Mentoring by Annotated Real- Time Video: SMARTv. Using an iPad and Apple Pencil, SMARTv allows a mentor to annotate live video of the surgical field, which is streamed to a trainee video monitor. Without scrubbing in, mentors can highlight teaching points directly on the iPad surgical field image and bookmark key moments, which can be archived for later debriefing and longitudinal assessment of improvement. To validate the effectiveness of SMARTv, we conducted a pilot study using open surgery of the perceived impact of SMARTv on the intraoperative educational experience of trainees and on the mentoring experiences of educators.
Methods: Following completion of SMARTv-guided open surgery, the trainees and their mentor completed a Likert scale (1-strongly disagree, 5-strongly agree) assessment questionnaire based on Kirkpatrick's model of effectiveness evaluation.
Results: To date, five (one mentor, four trainees) surveys were completed. SMARTv was used to guide trainees through hypospadias repairs and urethrocutaneous fistula repairs. All respondents agreed that the tool was easy to use (mean score 4.5/5) and improved instruction clarity and the quality (4.4) and quantity (4.2) of feedback. Four respondents agreed that the tool improved trainee autonomy (4.2). No one rated the tool as distracting (2.2). Many SMARTv-guided surgeries are scheduled for the upcoming months; more data will be obtained.
Conclusions: SMARTv is an innovative tool that provides close intraoperative guidance while maintaining trainee autonomy. We speculate this approach will extract greater learning from each case, require fewer cases to achieve competence in surgical training, and find a key role in the design of competency-based training. These goals await future long-term studies.