We need to be much more aware as clinicians — not just as surgeons — about our performance and the variability in our performance. And I believe that the video concept can play a significant role when it comes to evaluating performance and seeking improvement.
Landmark research has shown us that there is a connection between video evaluation and outcomes, although this may not be a causal relationship.
C-SATS’ video evaluation solution is great, in my opinion, and one of the main reasons is that it doesn’t require a hospital to use precious resources for assessment. This is the province of outside experts, which makes the evaluation cycle quicker and more relevant, too.
One of the keys here, in my view is how coaching plays into the video evaluation process. We have found that video coaching leads to significant improvement in surgery. That’s why I think it would be great if a surgeon could look at his or her video performance and video performance evaluation a er each and every case, while the details of the procedure are still fresh and top of mind. This works in football, where the team reviews game film and gets objective feedback from coaches after a contest is over, but before the next week of competition. This puts you solidly and squarely on the path to improvement.
To be completely fair, though, video evaluation isn’t always the answer — especially in surgical cases where the procedures and steps aren’t always clear and defined; or in cases that go on for a long period of time.
I’m also concerned that, as we embrace video evaluation in surgery, we don’t open Pandora’s Box, so that a patient can go back several years and look at what happened with an eye toward litigation.
But on the upside, I really would love to see video evaluation in surgery examine team interaction in the operating room. Research shows us that team harmony and efficiency leads to better outcomes. Maybe that’s the next frontier for C-SATS.
Rajesh Aggarwal MBBS, MA, PhD, FRCS — is Associate Professor of Surgery at McGill University Health Centre and Director of the Arnold and Blema Steinberg Medical Simulation Centre. His research interests focus on simulation-based training and assessment in medicine, measurement and improvement of clinical outcomes and patient safety. Immediately prior to joining McGill, Dr. Aggarwal served as an Instructor in Gastrointestinal Surgery, Department of Surgery, in the Perelman School of Medicine at the University of Pennsylvania. Additionally, he held the position of National Institutes of Health Research Clinician Scientist in Surgery, Division of Surgery, Department of Surgery and Cancer, at Imperial College London in the United Kingdom. Dr. Aggarwal began his medical training in 1993 at Selwyn College, Cambridge University, and completed his clinical medicine studies in 1999 at the Royal Free Hospital School of Medicine, University of London. He pursued surgical training in London teaching hospitals and his PhD at the University of London.Motivated by a keen interest in simulation for medical training, Dr. Aggarwal’s PhD thesis, “A Proficiency-Based Technical Skills Curriculum for Laparoscopic Surgery,” had as its aim developing curricula for basic, intermediate and advanced laparoscopic surgery using innate, virtual reality and cadaveric porcine simulations. His thesis sought to elucidate the effectiveness of virtual reality simulation-based training to shorten the learning curve on real procedures in a similar manner to the transfer-effectiveness ratio of flight simulation.