Clinical Trial Details
— Status: Terminated
Administrative data
NCT number |
NCT02986217 |
Other study ID # |
101614 |
Secondary ID |
|
Status |
Terminated |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
December 2016 |
Est. completion date |
February 2019 |
Study information
Verified date |
October 2022 |
Source |
George Washington University |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
This study seeks to establish the effect of regular structured feedback on surgical
performance using crowd sourced video assessments with validated objective performance scores
and time to complete a specific surgical procedure through a randomized controlled trial. The
working hypothesis is that regular structured assessment will lead to a greater measurable
improvement in performance, as defined by objective performance scores, than will traditional
feedback methods.
Description:
The American Association of Gynecologic Laparoscopists (AAGL) and Accreditation Council of
Graduate Medical Education (ACGME) have endeavored to implement structure and standardization
for the fellowship in minimally invasive gynecologic surgical programs (FMIGS) and obstetric
and gynecology residency programs respectively. Educational objectives are explicitly
delineated. Though the fellowship and residency educational objectives are well rounded, and
include the development of skills to become leaders and educators in the field of minimally
invasive gynecologic surgery (MIGS) and general obstetrics and gynecology, one of the main
objective of the fellowship and residency training is the attainment of surgical skill. This
is ensured by a requirement for a breadth of surgical exposure including vaginal surgery,
hysteroscopy, traditional laparoscopy, management of surgical complications, minimally
invasive hysterectomy, urogynecologic procedures, gastrointestinal surgery, urinary tract
surgery, reproductive surgery, and the surgical management of common gynecologic conditions
such as endometriosis. Minimum case requirements have been implemented to provide guidance
for FMIGS and residency programs. In addition, trainees are required to log surgical cases
and this information is utilized for FMIGS and residency program site inspections as well as
for feedback of surgical competency. Despite standardization efforts by the AAGL and ACGME,
the FMIGS and obstetric and gynecology residency curriculums are still in evolution. There is
likely still great variation in surgical exposure between programs. In addition, though
regular feedback is a requirement of training programs, the process is likely unstructured
and subjective; based on case logs, self-assessments, and feedback by faculty surgeons. There
is thus a critical need to develop a standardized, objective, timely, and actionable feedback
methodology to facilitate program oversight and ensure FMIGS fellows and obstetrics and
gynecology residents are achieving surgical competency throughout their training. In the
absence of such structured feedback models, it will remain difficult to optimize FMIGS
fellowship and obstetrics and gynecology resident training, and provide objective
measurements of the impact of such training on surgical performance and patient outcomes. .
The long-term goal of this study is to assist in developing methods for surgical assessment
that facilitate program oversight, allow fellows, residents, and program directors to
identify specific skill sets in need of improvement, monitor progress in skill acquisition,
and clearly and objectively document achievement of milestones throughout training. The
study's overall objective is to determine how consistent structured feedback using crowd
sourcing impacts time to complete a task as well as surgical performance as measured by GOALS
and GEARS scores. The central hypothesis is that fellows and residents who receive consistent
structured feedback over a sustained period of time will have shorter task times, overall
improved performance, and greater satisfaction than fellows and residents receiving
traditional feedback. The rationale for this work is that it will provide focus and
supportive data for large-scale studies of surgical skill acquisition and development.
This study seeks to establish the effect of regular structured feedback on surgical
performance using crowd sourced video assessments with GOALS and GEARS through a randomized
controlled trial. The study hypothesizes regular structured assessment will lead to a greater
measurable improvement in performance, as defined by change and GOALS and GEARS scores, than
will traditional feedback methods as well as time to complete a specific procedure.