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Abstract
Objective: Attaining operative skills is a core component of surgical training. Conventional teaching strategies are deprived of a systematic feedback method and scope for self-reflection. Video-based reflective learning has emerged as an effective method for cultivating technical competencies through standardised, guided feedback and self-evaluation. This study aimed to evaluate the effectiveness of video-based reflection on surgeons’ operative performance.
Methods: A pre-post quasi-experimental study was conducted at the Department of Surgery at IIMCT–PRH, Rawalpindi, after obtaining ethical approval. Using convenience sampling, 50 participants were enrolled; however, only 32 participants appeared on the pre-assessment day. Participants first performed suturing on a synthetic pad, which was video-recorded as baseline, followed by a training session after which they reviewed their own recordings for self-reflection. After 48 hours, the suturing task was repeated and video-recorded again. Both baseline and 48-hour recordings were scored by a blinded evaluator using OSATS, and pre- and post-scores were compared using a paired t-test.
Results: Most participants were medical students with minimal previous suturing experience and were less confident in their suturing skills. The frequent difficulties included handling the instrument, knot-tying, and proper spacing of sutures. The mean Objectively Structured Assessment Technical Skills (OSATS) score demonstrated a substantial improvement from 5.84 ± 1.08 to 9.46 ± 1.26 (p < 0.001).
Conclusion: Continuous improvement in medical and surgical sciences requires a transition in educational strategies from conventional to modern teaching methods. Video-based self-reflection with a systematic feedback mechanism has proven to be a promising learning and skill acquisition method, specifically among young trainees and medical students.
Keywords: Video Recording, Education, Medical, Clinical competence, Cognitive reflection, Surgical procedures, Audiovisual aids
References
Gathu C. Facilitators and barriers of reflective learning in postgraduate medical education: a narrative review. Journal of medical education and curricular development. 2022 May;9:23821205221096106. https://doi.org/10.1177/23821205221096106
MacAskill W, Chua WJ, Woodall H, Pinidiyapathirage J. Beyond the written reflection: a systematic review and qualitative synthesis of creative approaches to reflective learning amongst medical students. Perspectives on medical education. 2023;12(1):361-371. https://doi.org/10.5334/pme.914
Kava L, Jones K, Ehrman R, Smylie L, McRae M, Dubey E, et al. Video-assisted self-reflection of resuscitations for resident education and improvement of leadership skills: a pilot study. Perspectives on medical education. 2021;11(2):80-85. https://doi.org/10.1007/S40037-021-00690-9
Atkinson A, Watling CJ, Brand PLP. Feedback and coaching. European journal of pediatrics. 2022;181(2):441-
https://doi.org/10.1007/s00431-021-04118-8
Tejos R, Crovari F, Achurra P, Avila R, Inzunza M, Jarry C, et al. Video-based guided simulation without peer or expert feedback is not enough: a randomized controlled trial of simulation-based training for medical students. World journal of surgery. 2021;45(1):57-65. https://doi.org/10.1007/s00268-020-05766-x
Ogundiya O, Rahman TJ, Valnarov-Boulter I, Young TM. Looking back on digital medical education over the last 25 years and looking to the future: narrative review. Journal of medical internet research. 2024;26:e60312. https://doi.org/10.2196/60312
Augestad KM, Butt K, Ignjatovic D, Keller DS, Kiran R. Video-based coaching in surgical education: a systematic review and meta-analysis. Surgical endoscopy. 2020;34(2):521-535. https://doi.org/10.1007/s00464-019-07265-0
Pakkasjärvi N, Anand S, Anttila H, Pyhältö K. Self-regulated video-based learning for cultivating surgical skills: a systematic review and meta-analysis of randomized controlled trials. International medical education. 2023;2(3):141-150. https://doi.org/10.3390/ime2030014
Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondré K, Stanbridge D, et al. A global assessment tool for evaluation of intraoperative laparoscopic skills. The American journal of surgery. 2005;190(1):107-113. https://doi.org/10.1016/j.amjsurg.2005.04.004
Costa CDS, Silva GG, Santos ER, Lima ARA, Brienze VMS, Oliani DCMV, et al. Surgical residents’ feedback perceptions: a scoping review on gaps and improvements. The clinical teacher. 2026;23(1):e70323. https://doi.org/10.1111/tct.70323
Isreb S, Attwood S, Hesselgreaves H, McLachlan J, Illing J. Synchronized video-review as a tool to enhance reflection and feedback: a design-based feasibility study. Journal of surgical education. 2021;78(1):1-8. https://doi.org/10.1016/j.jsurg.2020.07.014
Ahmed I. Post graduate surgical training: past, present and future in Pakistan. Journal of pioneer medical sciences. 2015;5(2):34-35.
Greenberg CC, Dombrowski J, Dimick JB. Video-based surgical coaching: an emerging approach to performance improvement. JAMA surgery. 2016;151(3):282. https://doi.org/10.1001/jamasurg.2015.4442
Tantiphlachiva K, Iramaneerat C, Lertbunnaphong T. Improving surgical skills with feedback: directly-observed versus video-recorded practice. BMC medical education. 2023;23(1):660. https://doi.org/10.1186/s12909-023-04635-0
Pugh CM, Hashimoto DA, Korndorffer JR. The what? How? and who? of video based assessment. The American journal of surgery. 2021;221(1):13-18. https://doi.org/10.1016/j.amjsurg.2020.06.027
Naik ND, Abbott EF, Gas BL, Murphy BL, Farley DR, Cook DA. Personalized video feedback improves suturing skills of incoming general surgery trainees. Surgery. 2018;163(4):921-926. https://doi.org/10.1016/j.surg.2017.11.006
McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic medicine. 2011;86(6):706-711. https://doi.org/10.1097/ACM.0b013e318217e119
Hu Y, Tiemann D, Michael Brunt L. Video self-assessment of basic suturing and knot tying skills by novice trainees. Journal of surgical education. 2013;70(2):279-283. https://doi.org/10.1016/j.jsurg.2012.10.003
Gnanalingham S, Gnanalingham R, Gnanalingham K, Limbachia D. UK foundation trainee perceptions of surgical skills in the foundation training programme - a national survey. International journal of surgery protocols. 2025;29(1):1-5. https://doi.org/10.1097/SP9.0000000000000034
Jamshidi R, LaMasters T, Eisenberg D, Duh QY, Curet M. Video self-assessment augments development of videoscopic suturing skill. Journal of the American college of surgeons. 2009;209(5):622-625. https://doi.org/10.1016/j.jamcollsurg.2009.07.024
Farquharson AL, Cresswell AC, Beard JD, Chan P. Randomized trial of the effect of video feedback on the acquisition of surgical skills. British journal of surgery. 2013;100(11):1448-1453. https://doi.org/10.1002/bjs.9237
Briones-Zamora KH, Mora PD, Yépez IN, Salas GG, Briones-Zamora AD, Farfán AQ, et al. Can ChatGPT Teach Tendon Repair Suturing? A Comparison With Video Instruction in a Simulation-Based Environment: A Pilot Study. J Surg Educ. 2026 May 1;83(5):103867. https://doi.org/10.1016/j.jsurg.2025.103867
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