Video review program enhances resident training in laparoscopic inguinal hernia: a randomized blinded controlled trial.

BACKGROUND: The purpose was to determine if a standardized video review program for residents improves operative performance.

METHODS: Participation was offered to surgical residents rotating on a minimally invasive service. Residents were randomized to either the video review group or no video review group. Every participant in the video review group underwent video reviews with an attending surgeon for 30 min once weekly during their 1-month rotation. A blinded surgeon evaluated performance in the operating room using validated assessment tools. The amount of time the resident spent as primary surgeon was recorded. One-way analysis of variance was used to compare the video and no video review groups. Differences were considered statistically significant for p values < 0.05.

RESULTS: Sixteen residents were randomized to the video review group (n = 8) or the no video review group (n = 8). Residents in the video review cohort significantly improved in creating a working space (p = 0.04), hernia sac reduction (p = 0.01), mesh placement (p = 0.01), knowledge of the procedure (p = 0.01), and overall competence (p = 0.02). Residents in the no video review group did not significantly improve in five of seven categories. The video review group significantly increased the time spent as primary surgeon (p = 0.02).

CONCLUSION: Video review with a coach proved to be beneficial for residents when learning laparoscopic inguinal hernia repairs. We conclude that systematic video review is a good supplemental tool in resident surgical training.