Real-scene teaching based on live demonstration systems: Application and effect evaluation in hepatobiliary surgical training—Taking laparoscopic cholecystectomy as an example_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CAI Yunshi¹ ¹ , DENG Ying² ² ,  WU Hong¹ ¹

1. Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Whole-Process Management Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WU Hong¹, Email: wuhong@scu.edu.cn

Keywords：

live-streaming demonstration system; real-scenario teaching; critical view of safety scoring; hepatobiliary surgery; laparoscopic cholecystectomy

DOI：

10.7507/1007-9424.202504118

Video：

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Objective To preliminarily explore application and effectiveness of real-scene teaching based on a live demonstration system in hepatobiliary surgical training, using laparoscopic cholecystectomy (LC) as an example. Methods From March 2023 to February 2024, 60 surgical residents undergoing a 4-month standardized residency training at the Liver Transplant Center of West China Hospital, Sichuan University, were randomly assigned into an observation group (n=30) and a control group (n=30) using a random number table. The observation group received real-scene surgical teaching based on the live demonstration system, while the control group received traditional teaching methods. At the end of the training, both groups underwent an operative assessment on LC and completed a resident satisfaction questionnaire. Operative assessment used critical view of safety (CVS) scoring to evaluate surgical safety. Resident satisfaction was assessed using a self-designed questionnaire covering five domains: stimulating the learning atmosphere, increasing learning engagement, improving surgical proficiency, enhancing the understanding of surgical complications, and recognition of the teaching model. The final results were categorized as positive or negative evaluations. The significance level was set at α=0.05. Results The observation group had significantly higher CVS score than the control group [4.2±1.3 vs. (2.8±1.7), t=3.57, P=0.001]. All 60 questionnaires were collected, and the observation group reported significantly higher positive evaluations in improving surgical proficiency, enhancing the understanding of surgical complications, and recognition of the teaching model compared to the control group (P<0.05). There were no statistically significant differences between the two groups regarding positive evaluations for stimulating the learning atmosphere and increasing learning engagement (P>0.05). Conclusion The results of this study suggest that the real-scene teaching model based on a live demonstration system demonstrates good effectiveness in hepatobiliary surgical training and can improve the quality of surgical teaching during standardized residency training for surgical residents.

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1. Chandra A, Rajesh A, Backstrom C, et al. Training, testing and remediating: the importance of simulation for surgical trainees. ANZ J Surg, 2019, 89(11): 1364-1365.
2. McGaghie WC, Issenberg SB, Petrusa ER, et al. A critical review of simulation-based medical education research: 2003–2009. Med Educ, 2010, 44(1): 50-63.
3. Qureshi AA, Zehra T. Simulated patient’s feedback to improve communication skills of clerkship students. BMC Med Educ, 2020, 20(1): 15. doi: 10.1186/s12909-019-1914-2.
4. Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg, 1995, 180(1): 101-125.
5. Strasberg SM, Brunt LM. Rationale and use of the critical view of safety in laparoscopic cholecystectomy. J Am Coll Surg, 2010, 211(1): 132-138.
6. Zhang J, Luo Z, Zhang R, et al. The transition of surgical simulation training and its learning curve: a bibliometric analysis from 2000 to 2023. Int J Surg, 2024, 110(6): 3326-3337.
7. Zendejas B, Brydges R, Hamstra SJ, et al. State of the evidence on simulation-based training for laparoscopic surgery: a systematic review. Ann Surg, 2013, 257(4): 586-593.
8. Bouthors C, Dagneaux L, Boisgard S, et al. Procedural simulation training in orthopaedics and traumatology: Nationwide survey among surgeon educators and residents in France. Orthop Traumatol Surg Res, 2022, 108(8): 103347. doi: 10.1016/j.otsr.2022.103347.
9. Lowry B, Johnson GGRJ, Vergis A. Merged virtual reality teaching of the fundamentals of laparoscopic surgery: a randomized controlled trial. Surg Endosc, 2022, 36(9): 6368-6376.
10. Weiss KB. Introductory remarks by the president of the American Board of Medical Specialties. Acad Emerg Med, 2008, 15(11): 982-983.
11. Kantamaneni K, Jalla K, Renzu M, et al. Virtual reality as an affirmative spin-off to laparoscopic training: An updated review. Cureus, 2021, 13(8): e17239. doi: 10.7759/cureus.17239.

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