Training in soft-tissue resection using real-time visual computer navigation feedback from the Surgery Tutor: a randomized controlled trial

• Published in: Canadian Journal of Surgery Vol. 64; p. S65
• Main Authors: Poole, Meredith, Ungi, Tamas, Fichtinger, Gabor, Zevin, Boris
• Format: Journal Article
• Language: English
• Published: Ottawa CMA Impact, Inc 01.11.2021
• Subjects: Clinical trials; Feedback; Surgery
• ISSN: 0008-428X

Background: In competency-based medical education (CBME), surgery trainees are often required to learn procedural skills in a simulated setting before proceeding to the clinical environment. The Surgery Tutor computer navigation platform allows for real-time proctorless assessment of open soft-tissue resection skills; however, the use of this platform as an aid in acquisition of procedural skills is yet to be explored. Methods: In this prospective randomized controlled trial, 20 final-year medical students were randomized to receive either training with real-time computer navigation feedback (intervention group, n = 10) or simulation training without navigation feedback (control group, n = 10) during resection of simulated non-palpable soft-tissue tumours. Real-time computer navigation feedback allowed participants to visualize the position of their scalpel relative to the tumour. Computer navigation feedback was removed for postintervention assessment. The primary outcome was the positive margin rate. Secondary outcomes were procedure time, mass of tissue excised, number of scalpel motions and distance travelled by the scalpel. Results: Training with real-time computer navigation resulted in a significantly lower positive margin rate compared with training without navigation feedback (0% v. 40%, p = 0.025). All other performance metrics did not differ significantly between the groups. Participants in the intervention group showed significant improvement in positive margin rate from baseline to final assessment (80% v. 0%,p < 0.01), whereas participants in the control group did not. Conclusion: Real-time visual computer navigation feedback from the Surgery Tutor resulted in superior acquisition of procedural skills than training without navigation feedback.