Direct Observation vs Video Review of Laparoscopic Gynecologic Cases and their Effect on Evaluation

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Faculty Advisor:Arthur Ollendorff, MDPURPOSE:To demonstrate that delayed video evaluation of laparoscopic procedures is consistent with real time evaluation.BACKGROUND:Fewer Gynecologic surgeries are being performed annually in residency, which creates a challenge in evaluating competency for graduating residents. If our hypothesis is affirmed it would allow residents to submit their procedures electronically for evaluation thus allowing for a more comprehensive evaluation of their skills, higher volume of evaluations and more individualized control over the residents' education and development.METHODS:Women undergoing a laparoscopic gynecologic surgery in which something was removed from the body were eligible for the study and signed consents to have their cases recorded. After completion of the procedure the attending physician would fill out a GOALS assessment of the case. The video was then uploaded to a secure on-line file storage system and reevaluated by two other attending physicians using the same GOALS assessment sheet. Results of the separate assessments were analyzed using Student's T test.RESULTS:A total of 29 real time and 24 video evaluations were performed. The mean composite GOALS scores were not significantly different with 17.14 and 16.30 for real time and video review respectively (P=.30). Among the GOALS individual components only efficiency showed a statistical difference with video review demonstrating lower scoring (P=.03).DISCUSSION:Real time and delayed video evaluation of resident skills yield similar results in laparoscopic gynecologic cases.

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