Minor surgery course using remote and asynchronous feedback: training wherever, whenever

Global Surgical Education - Journal of the Association for Surgical Education(2023)

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Abstract
Purpose Achieving mastery in suturing and minor surgery procedures is relevant for general practitioners who due to geographical barriers have scarce access to training. This study aims to share the experience of scaling up a minor surgery course to an online platform across the country. Methods A formerly in-person minor surgery course was adapted into an online platform in which trainees watched tutorials, trained at-home unsupervised, and then uploaded their attempts, receiving feedback in a remote and asynchronous manner. Feedback inputs were given in four modalities: onscreen drawings, texts, audio, and common mistakes videos. A “surgical kit” was delivered to every student. Trainees were asked to perform basic suturing and five minor surgery procedures: onychocryptosis surgery, cyst removal, nevus removal, abscess drainage, and advancement flap. A group of seven standardized teachers rated all procedures using a modified OSATS Global Rating Scale (GRS) and Procedure-Specific Rating Scales (SRS). The approval criteria for basic suturing skills was established with a minimum of 20 points for global GRS and 16 points in the case of SRS. For the other procedures, the approval criteria was established only using the SRS, with a minimum of 24 points and 21 points, only in the case of the advancement flap. Results A total of 128 students underwent the course, of which 109 (85.16%) completed it. A total of 1433 videos were uploaded to the platform, receiving 7205 feedback inputs. In basic suturing skills, an average passing score of 23.1 ± 2.1 was obtained meanwhile for onychocryptosis surgery the average passing scores was 22.4 ± 1.71, for cyst removal 22.1 ± 2.1, for nevus removal 22.2 ± 1.72, for abscess drainage 23.0 ± 1.4, and for advancement flap,19.9 ± 1.7. Conclusion It is feasible to teach a minor surgery skills course through remote and asynchronous feedback using a digital platform. Further studies are needed to assess skills transfer and retention.
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Key words
Minor surgery,Simulation training,Surgical education technology,Tele-mentoring,Tele-simulation education,Clinical competence,Surgery training/courses
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