Comparative effectiveness of supervised versus unsupervised video training on hysteroscopic camera navigation performance among OB-GYN residents at Tertiary Government Hospital: A randomized controlled trial

BACKGROUND: Simulated video training has emerged as an effective method to enhance the surgical skills. However, in the local context, there is an absence of data contrasting the outcomes of unsupervised video training with the conventional supervised approach in surgical skill development. OBJECTIVE: The objective of this study was to evaluate and contrast the performance score and total operating time between unsupervised video training simulations and supervised video training simulations, specifically in the domain of 30° hysteroscopic camera navigation. MATERIALS AND METHODS: A single-blinded randomized controlled trial involved 24 obstetrics and gynecology residents in a tertiary government institution. Participants were randomized into Group A (unsupervised video training) and Group B (proctor-supervised simulation training). Utilizing a uterine model, both groups undertook nine designated tasks. The training process included a pretest simulation, 5 training repetitions, and a concluding posttest simulation. The principal investigator documented operating times and hand movements posteach session. Subsequently, a blinded Philippine Society for Gynecologic Endoscopy board-certified gynecologic endoscopist assessed these videos, using the Global Hysteroscopy Rating Scale for scoring. RESULTS: The total operating time and performance score during posttest among Group A and Group B showed no significant difference (Group A 0.77 ± 0.19 min Group B 0.71 ± 0.15 min) ( P = 0.377) (Group A 13.50 ± 1.73 Group B 13.83 ± 1.53) ( P = 0.622) which suggest that participants performed comparably regardless of instructional method. On the Global Rating Scale (GRS) score, higher percentage of participants from Group B showed improved performance on respect for tissue, time and motion, and handling of hysteroscope as compared to Group A. CONCLUSION: The video-based training simulation is effective as expert proctoring in hysteroscopic camera navigation. However, there was slightly greater improvement in the GRS scores in the proctor supervised group which suggest that feedback from proctors has a positive impact on the performance.