Grants

"“Neurosurgery cannot be mastered in the classroom or a textbook. It has to be learned by actually performing procedures. Supplementing that hands-on training with video replays and debriefing by an experienced surgeon will enhance their skills and patient outcomes.” Nitin Agarwal, MD, UPMC Presbyterian, Department of Neurological Surgery

VISION: Video Integration for Surgical Improvement of Outcomes after Neurosurgery

Grant Application

Nitin Agarwal, MD, Ahmed Kashkoush, B.S., Juan C. Fernandez-Miranda, M.D., and Paul A. Gardner, MD, UPMC Presbyterian, Department of Neurological Surgery

Proposed Innovation

Neurosurgical residents develop their skills through active, experiential learning that is followed by reflection and analysis. Although trainees are involved in the operating room, there are limited opportunities for self-assessment of their technical skills.

Inspired by instant replay systems used in sports, a video feedback system will serve as a debriefing tool for residents following hands-on surgical training in the operating room.

Improvements in Action

Through this innovative project, digital video editing, analysis, and playback software be developed with such features as motion instant replay, coaching highlight tools, and event data logging. The goal is to increase the surgical skills and decrease and technical errors of trainees, which may ultimately improve patient outcomes.

Intended Outcomes

Residents recruited from the neurological surgery program will be divided into two groups. During the first 6 months, the control group will perform basic endoscopic procedures under the supervision of an attending neurosurgeon. They will receive standard one-on-one training with the primary surgeon, but no other interventions. The intervention group will undergo similar training, but it will be supplemented with a weekly 1-hour debriefing session with the attending surgeon for review and self-evaluation. After 6 months, the two groups will crossover.

Surgical skills will be evaluated at baseline, after the initial 6-month training period, and after the second 6 months of training following the crossover period. Outcomes also will be measured to evaluate usefulness, number of staff takeovers during the procedure, time commitment of participants, patient comprehension, and patient satisfaction.