Video-Based Coaching for Laparoscopic Salpingectomy: A Randomized Controlled Trial

We read with great interest the study by Muir et al in the September 2024 issue.1 We are concerned, however, with the choice of a randomized trial. Where was the equipoise in delivering private coaching from an expert to only half of the residents? Introspection during trial planning would have revealed a reasonable certainty that the residents not receiving private coaching would perform worse. Half of your residents were likely disappointed that they were not selected for one-on-one sessions with a surgical expert. We are with the Association of Professors of Gynecology and Obstetrics Surgical Education Scholars program, where the faculty encourage the scholars to use a preintervention and postintervention design when studying surgical education innovations that are likely to benefit all learners. The randomized study design, although appropriate for certain clinical trials, results in a lack of parity in surgical education trials, disadvantaging the participants not receiving the intervention. Furthermore, the conclusion that extra education improves surgical learning and performance typically is not an interesting finding.2