Home-based training for first-year surgery residents: learning to perform an open manual intestinal anastomosis with remote and asynchronous feedback

This study explores the feasibility of remote training for complex surgical skills through an at-home open manual intestinal anastomosis (MIA) program for 1 year surgery residents.

A quasi-experimental design assessed an open MIA training module. It included (1) an MIA video tutorial, tutored class, and in-person feedback, and (2) at-home training with remote asynchronous feedback. Trainees video-recorded and uploaded their MIA attempts to receive feedback through a digital platform. All program completions between July 2021 and October 2022 were included. Two evaluators, blind to the participants and to the timing of the videos, assessed residents’ performance using global (GRS) and procedure specific (SRS) ratings scales, and measured procedural time. Pre-post analysis utilized first and last uploaded videos. A satisfaction survey gauged residents’ perception. Non-parametric statistics were used (p < 0.05).

Fourteen residents completed the training program. Pre-post video assessments showed a non-significant trend towards improved GRS and SRS scores, with decreased procedural time. Median GRS scores were 15.75 vs. 15.75 (p = 0.71), and SRS scores were 13.5 vs. 14.5 (p = 0.85). Procedural time decreased from 34 to 32.1 min (p = 0.40). Among survey respondents, 71% found feedback helpful for error correction and skill improvement, and 86% reported increased confidence in performing open MIA.

Implementing an at-home training program for complex surgical skills is feasible. Remote and asynchronous digital feedback holds promise for enhancing technical skills, though further research is necessary to understand the learning process, and additional training sessions may be needed.