LETTER TO THE EDITOR
Should We All Join the YouTube Generation?
Dear Editor, I was very interested in reading the recent article by Hu et al.1 regarding the use of video self-assessment for basic suturing and knot-tying skills by novice trainees, particularly the fact that novice trainees often overestimate their basic technical skills. With the reduction in working hours and increasing pressures in theater productivity, there is perhaps a certain pressure on trainees to be overconfident in their own skills so that they are given the opportunity to perform cases. Video technology is being used increasingly in surgical training and some courses and lecture rely on video links and live surgery footage to train and educate.2 With the development of smaller, higher-quality high-definition video cameras, video training is a potential area of education that can become available to a wider audience. In our institution, we have used a portable lightweight high-definition head-mounted video camera (Gopro HD Hero 3 Black Edition, Woodman Labs, Half-Moon Bay, California) to record orthopedic operations. The advantages over previously used cameras are several. These include the following: An unobstructed bird’s-eye view of the surgeon performing the operation. A high-definition sound recording that allows a running commentary. As they are commercially available at relatively low cost, videos may be edited and published accordingly. This is used only in select patients who have provided special written consent for medical photography and all videos have been stored on a password-protected hospital computer. Specifically for trainees, this allows assessments of cases by the consultant for which they were not present. The audio commentary provides invaluable real-time feedback that can be reflected upon on review of the videos. With shiftpattern working, trainees often have limited exposure to their supervising consultant. This means that trainees are often not given the opportunity to perform many cases as their consultant is unsure of their operative skill. Video assessments may address this significant issue and enable consultants to have the confidence in allowing their trainees
162
to perform cases, as they would have a better understanding of their operative experience and skill. This in turn may help alleviate the necessity for trainees to overestimate their skills so as to try and talk their way into being given operative experience. In time and with increased utilization, video recordings would narrow the gap between selfassessment and expert-assessment of trainees’ operative skills so that it becomes a valuable educational resource.3 With the move toward competency-based assessment and training, perhaps there may be a time when online portfolios will include operative videos performed by trainees that could then be independently assessed by their supervising consultant providing meaningful and instructive feedback. In addition, videos may be uploaded for training and educational purposes to lead to the development of webbased educational resources. More specifically, some deaneries are planning to create their own training website, and we find this technology to be valuable. By creating a simple easy-to-use video resource, we would hope that trainees would be able to overcome some of the traditional difficulties in using video technology and utilize it as a routine part of their training. Piyush Mahapatra, MRCS Edmund Leong, MRCS West Middlesex University Hospital, London, United Kingdom
REFERENCES 1. Hu Y, Tiemann D, Brunt LM. Video self-assessment of
basic suturing and knot tying skills by novice trainees. J Surg Educ. 2013;70(2):279-283. 2. Roser F, Pfister G, Tatagiba M, Ebner FH. Live surgery
in neurosurgical training courses: essential infrastructure and technical set-up. Acta Neurochir (Wien). 2013;155 (3):541-545. 3. Driscoll PJ, Paisley AM, Paterson-Brown S. Video
assessment of basic surgical trainees’ operative skills. Am J Surg. 2008;196:265-272.
Journal of Surgical Education & 2014 Association of Program Directors in Surgery. Published by 1931-7204/$30.00 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jsurg.2013.07.004
Should We All Join the YouTube Generation?
Dear Editor, I was very interested in reading the recent article by Hu et al.1 regarding the use of video self-assessment for basic suturing and knot-tying skills by novice trainees, particularly the fact that novice trainees often overestimate their basic technical skills. With the reduction in working hours and increasing pressures in theater productivity, there is perhaps a certain pressure on trainees to be overconfident in their own skills so that they are given the opportunity to perform cases. Video technology is being used increasingly in surgical training and some courses and lecture rely on video links and live surgery footage to train and educate.2 With the development of smaller, higher-quality high-definition video cameras, video training is a potential area of education that can become available to a wider audience. In our institution, we have used a portable lightweight high-definition head-mounted video camera (Gopro HD Hero 3 Black Edition, Woodman Labs, Half-Moon Bay, California) to record orthopedic operations. The advantages over previously used cameras are several. These include the following: An unobstructed bird’s-eye view of the surgeon performing the operation. A high-definition sound recording that allows a running commentary. As they are commercially available at relatively low cost, videos may be edited and published accordingly. This is used only in select patients who have provided special written consent for medical photography and all videos have been stored on a password-protected hospital computer. Specifically for trainees, this allows assessments of cases by the consultant for which they were not present. The audio commentary provides invaluable real-time feedback that can be reflected upon on review of the videos. With shiftpattern working, trainees often have limited exposure to their supervising consultant. This means that trainees are often not given the opportunity to perform many cases as their consultant is unsure of their operative skill. Video assessments may address this significant issue and enable consultants to have the confidence in allowing their trainees
162
to perform cases, as they would have a better understanding of their operative experience and skill. This in turn may help alleviate the necessity for trainees to overestimate their skills so as to try and talk their way into being given operative experience. In time and with increased utilization, video recordings would narrow the gap between selfassessment and expert-assessment of trainees’ operative skills so that it becomes a valuable educational resource.3 With the move toward competency-based assessment and training, perhaps there may be a time when online portfolios will include operative videos performed by trainees that could then be independently assessed by their supervising consultant providing meaningful and instructive feedback. In addition, videos may be uploaded for training and educational purposes to lead to the development of webbased educational resources. More specifically, some deaneries are planning to create their own training website, and we find this technology to be valuable. By creating a simple easy-to-use video resource, we would hope that trainees would be able to overcome some of the traditional difficulties in using video technology and utilize it as a routine part of their training. Piyush Mahapatra, MRCS Edmund Leong, MRCS West Middlesex University Hospital, London, United Kingdom
REFERENCES 1. Hu Y, Tiemann D, Brunt LM. Video self-assessment of
basic suturing and knot tying skills by novice trainees. J Surg Educ. 2013;70(2):279-283. 2. Roser F, Pfister G, Tatagiba M, Ebner FH. Live surgery
in neurosurgical training courses: essential infrastructure and technical set-up. Acta Neurochir (Wien). 2013;155 (3):541-545. 3. Driscoll PJ, Paisley AM, Paterson-Brown S. Video
assessment of basic surgical trainees’ operative skills. Am J Surg. 2008;196:265-272.
Journal of Surgical Education & 2014 Association of Program Directors in Surgery. Published by 1931-7204/$30.00 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jsurg.2013.07.004
