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Impact of Video-Based Coaching on Gynecologic Resident Laparoscopic Suturing

BACKGROUND: Laparoscopic surgery affords patients superior outcomes to traditional open surgery. Despite this ubiquitous data, barriers to implementation stem from current resident training, including work hour restrictions and increased procedural oversight, thus necessitating greater emphasis on simulation curriculums. Coaching enhances performance by identifying, focusing on, and achieving specifics goals. Historically attributed to athletics, performance coaching has become a professional development tool in business, education and medicine. Thus, we aimed to evaluate the addition of video-based coaching to an established laparoscopic simulation curriculum on suturing performance. METHODS: Twenty OB/GYN residents (7-R1s, 7-R2s, 5-R3s and 1-R4) undergoing a 5-week laparoscopic simulation curriculum were video-recorded weekly performing a suturing task. Residents were randomized to receive standard curriculum or standard curriculum plus weekly video review/coaching meetings with a single expert laparoscopic surgeon. Two different expert laparoscopic surgeons independently graded videos. Primary outcome measure was comparison of weekly GOALS score of the suturing task. RESULTS: R3s started with significantly higher GOALS scores than R1 and R2s (P<.001), with no difference in GOALS scores across groups (P=.406). All residents showed significant improvement in suturing over the 5-week period (P=.005), with R1s showing greater improvement than R3s (P=.001). There were significantly improved GOALS average scores following the initial video intervention in R1/R2s compared to the control R1/R2s (3.14 versus 3.79, P<.043) with more gradual improvement seen in both groups in subsequent weeks. DISCUSSION: Video-based coaching during simulation training has its greatest impact early on novice learners skill acquisition, providing another tool to supplement simulation training.