Table 2 Summary of key studies demonstrating potential digital solutions to training issues
Training issue | Potential digital solution | Key studies | Study design | Learner groups | Conclusions |
|---|---|---|---|---|---|
Formative experience | Touch SurgeryTM | Kowalewski et al. (2017) [35] | Randomised cross over study | Medical students Junior trainee Senior trainee | Face, content and construct validity of Touch SurgeryTM Cognitive skills transfer more successful with VR simulation Valuable training experience with Touch SurgeryTM |
| Â | Touch SurgeryTM | Chidambaram et al. (2019) [36] | RCT | Medical students | Superior cognitive performance scores in Touch SurgeryTM group compared to control |
Acquisition of basic laparoscopic skills | VR Simulation | Nagendran et al. (2013 [21] | Systematic review and meta-analysis of RCTs | Surgical trainees | VR training improves operative performance compared to box-trainer or no supplementary training |
Operative experience | Video-based education | Ahmet et al. (2018) [68] | Systematic review of RCTs | Medical students Surgical trainees | Video-based education associated with higher performance score and trainee satisfaction |
Constructive feedback | Coaching with video analysis | Grantcharov et al. (2007) [38] | Interventional study | 2 surgical trainees | Constructive coaching with video analysis improved global assessment score |
| Â | Coaching with VR Simulation | Cole et al. (2014) [22] | RCT | Junior trainees | Reduction in errors and improvement of CAT over time with additional coaching |
Assessment of skill | Peer review of video | Birkmeyer et al.(2013) [50] | Observational/feasibility | Surgeons | Poor technical skills associated with postoperative complication Peer assessment of video successful |
| Â | Automated video assessment | Twinanda et al. (2017) [73] | Experimental | Surgeons | Accurate phase prediction and instrument recognition in laparoscopic cholecystectomy |
| Â | Automated video assessment | Hashimoto et al. (2019) [74] | Experimental | Surgeons | Accurate phase prediction and instrument recognition in laparoscopic sleeve gastrectomy video |
| Â | Automated video assessment | Jin et al. (2018) [76] | Experimental | Surgeons | Instrument tracking suitable for inferring laparoscopic skills in laparoscopic cholecystectomy video |
| Â | Automated video assessment | Kitaguchi et al. (2020) [75] | Experimental | Surgeons | Accurate phase prediction and instrument recognition in laparoscopic left sided-colorectal resection video |
| Â | Automated live video assessment | Winter Beaty et al. (2019) [52] | Experimental | Surgeons | Accurate phase prediction and in laparoscopic sleeve gastrectomy live video |
Supporting independent operating | AR and Tele-surgery | Greenfield et al. (2018) [43] | Case Study | Surgeons | Successful international audio-visual communication with interactive graphical overlay |
Surgical skill acquisition | AR telemontoring and simulated skills | Vera et al. (2014) [45] | RCT | Medical students | Faster skill acquisition in simulation with AR telementoring mentoring |
Surgical teamwork | Black box analysis | Kolodzey et al.(2019) [83] | Observational | Single surgeon | Surgical “near misses’ prevented by non-technical skills |
| Â | Tele-surgery | Lin et al. (2020) (44) | Feasibility | Orthopaedic surgeons | Live streaming and tele-mentoring during arthroscopy |