• Benjamin P Crawshaw, Scott R Steele, Edward C Lee, Conor P Delaney, W Conan Mustain, Andrew J Russ, Skandan Shanmugan, and Bradley J Champagne.
• 1 Department of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio 2 Department of Colorectal Surgery, Madigan Army Medical Center, Fort Lewis, Washington 3 Department of Colorectal Surgery, Albany Medical Center, Albany, New York.
• Dis. Colon Rectum. 2016 Jan 1; 59 (1): 28-34.

BackgroundLaparoscopic colorectal resection is an index case for advanced skills training, yet many residents struggle to reach proficiency by graduation. Current methods to reduce the learning curve for residents remain expensive, time consuming, and poorly validated.ObjectiveThe purpose of this study was to assess the impact of the addition of a preprocedural instructional video to improve the ability of a general surgery resident to perform laparoscopic right colectomy when compared with standard preparation.DesignThis was a single-blinded, randomized control study.SettingsFour university-affiliated teaching hospitals were included in the study.ParticipantsGeneral surgery residents in postgraduation years 2 through 5 participated.InterventionResidents were randomly assigned to preparation with a narrated instructional video versus standard preparation.Main Outcome MeasuresResident performance, scored by a previously validated global assessment scale, was measured.ResultsFifty-four residents were included. Half (n = 27) were randomly assigned to view the training video and half (n = 27) to standard preparation. There were no differences between groups in terms of training level or previous operative experience or in patient demographics (all p > 0.05). Groups were similar in the percentage of the case completed by residents (p = 0.39) and operative time (p = 0.74). Residents in the video group scored significantly higher in total score (mean: 46.8 vs 42.3; p = 0.002), as well as subsections directly measuring laparoscopic skill (vascular control mean: 11.3 vs 9.7, p < 0.001; mobilization mean: 7.6 vs. 7.0, p = 0.03) and overall performance score (mean: 4.0 vs 3.1; p < 0.001). Statistical significance persisted across training levels.LimitationsThere is potential for Hawthorne effect, and the study is underpowered at the individual postgraduate year level.ConclusionsThe simple addition of a brief, narrated preprocedural video to general surgery resident case preparation significantly increased trainee ability to successfully perform a laparoscopic right colectomy. In an era of shortened hours and less exposure to cases, incorporating a brief but effective instructional video before surgery may improve the learning curve of trainees and ultimately improve safety.

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