Advancing Surgical Training Beyond the Procedure Room Walls

As medical technology continues to evolve and advance, surgeons and physicians must learn how to integrate those new technologies into their practice, which requires  instruction and guidance in the clinical context. 

Advances in medicine have included the development of software platforms that provide the kind of context-rich virtual environments where the full clinical context can be shared. These telementoring platforms offer a way to collaborate within facilities, across countries and from continent to continent.

Trying to flatten the learning curve

A 2010 study by Dr. Peter Densen with the University of Iowa examining the challenges facing medical education offered a prescient and eye-opening look at the future needs of medical training. It was estimated in 1950 that the doubling time of medical knowledge was 50 years, a figure that dropped to seven years by 1980 and was further cut in half by 2010. The doubling of medical knowledge in 2020 was estimated at 73 days.

While Dr. Densen’s study focused on medical school education, it illustrates the challenges practicing surgeons and physicians can face around the need for continued training coupled with greater demands on their time.

Complex procedures such as an esophagectomy, for instance, have a high learning curve that require repetition to master, but it’s a low-volume procedure, so it can be difficult to gain enough clinical experience., Telementoring allows an experienced surgeon to support other surgeons remotely to help them hone their skills, proficiency and decision-making in complex, specialized surgeries.

Closing the geographic gap

Along with helping doctors close the knowledge gap, telementoring can close the geographic gap, an attractive benefit for surgeons practicing in rural areas where the next nearest hospital could be hundreds of miles away. A survey of surgeons, the vast majority of whom practiced in communities of populations fewer than 50,000, showed that more than 75% of them felt telementoring would be beneficial to their practices.

The most useful benefits of telementoring cited were learning new techniques and assistance with unexpected findings. Those surveyed also indicated they’d be interested in using telementoring for trauma consultation.4

In an example of trans-Atlantic mentoring, an experienced skull base team at the University of Pittsburgh Medical Center mentored nearly a dozen endoscopic endonasal surgeries of the skull base with surgeons at a university in Slovenia. Diagnoses had included cerebrospinal fluid leak, benign and malignant neoplasm and inflammatory disease, and the more experienced mentors provided real-time communication to the more junior surgical team to help identify anatomy and offer guidance on surgical technique.

Today’s telementoring platforms create a context-rich clinical environment through inclusion of two-way audio, high-resolution visuals,  “over-the-shoulder views” of a procedure,  and telestration, which enhances verbal instruction by visually highlighting anatomy or areas of interest during a procedure. Data suggests that telestration during a procedure can reduce the time of a telementored session by more than 30%.

As an important educational tool, telementoring can open ORs and procedure rooms to scores of surgeons without opening a single door. And while face-to-face training and mentorship may be preferred, in-person learning may not always be the most cost- and time-effective option.

Training the next generation of surgeons

The benefits of collaboration platforms reach well beyond practicing surgeons. Each procedure performed adds to a growing library of information that’s available to the next generation of physicians, who can learn from procedures and clinical collaboration.

A recently published study looked at the use of a telementoring platform during a hybrid observership at the Mayo Clinic Rochester for premedical students. The students joined a thoracic surgeon’s patient consultations and surgeries virtually, while also having the opportunity to enter the OR in person. Meeting patients face-to-face and stepping into an operating room was the preferred way to learn, but telementoring offers flexibility and accessibility when geographic and economic barriers exist for medical students. The study notes the unique possibilities for an entire anatomy class to complete a section of curriculum and then observe a relevant procedure remotely.

It’s unlikely that the pace of medical advancement will slow down any time soon. That’s why it’s so important for surgeons to take advantage of telementoring technology to keep pace with the technology that’s rapidly developing around them.

Ross D. Segan, MD, MBA, FCAS, is Chief Medical Officer Olympus Corporation

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