Abstract
BACKGROUND: The surgical trainee of today completes their postgraduate training with significantly less exposure than their mentors. The enforced reduced working hours, along with other factors, have created a gap in surgical training. Video-based coaching (VBC) provides an opportunity to improve the surgical technical skill without needing to increase surgical volume. The aim on this study is to investigate the effect of VBC on the surgical technical skill. METHODS: A systematic review of randomized controlled trials was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Bias was assessed for using The Cochrane Collaboration's tool for assessing risk of bias. The study was prospectively registered in the Open Science Framework (https://osf.io/sp8rb). Multiple subgroup analyses and meta-analyses were carried out, with results reported as standardized mean differences (SMDs) in performance scores and presented as forest plots. RESULTS: A total of 15 studies comprising 382 participants were included in the final analysis. From these 15 studies, 201 participants received VBC following a range of surgical procedures. On meta-analyses, the average performance scores for VBC were significantly higher than the controls (SMD 0.71, 95% CI 0.37, 1.04, Z = 4.15, and p < 0.0001) as were the average change scores from baseline to final performance (SMD 0.98 [95% CI 0.61, 1.35, Z = 5.19, and p < 0.0001]). Furthermore, the overwhelming majority of VBC participants across the studies found VBC to a be useful training tool. CONCLUSIONS: This review represents the most comprehensive assessment of the impact of VBC in surgery and demonstrates it to be an effective training tool in improving surgical technical skill acquisition. Training bodies around the world should now look at how best to formally integrate VBC into conventional surgical training.