From potential to practice: challenges implementing video review technology in the operating room

Abstract Purpose Considering traditionally poor uptake of video review to support operative skill acquisition, we studied surgical trainees’ perspectives during implementation of the BlackBox Explorer (BBX) video-based teaching and assessment system. Methods This interview study included residents and fellows completing their surgical rotations at a Community Hospital affiliated with the University of Toronto. We used a team-based approach to complete a reflexive thematic analysis. Results Analysis of 11 interviews ( N = 10 residents and N = 1 fellow) generated three themes: (i) Technology is merely a tool, and tools need to work well, (ii) Routinizing a new technology into clinical practice, and (iii) Motivating a new learning practice. Implementation challenges did not dissuade some participants from valuing the BBX. Conclusions We found that a relatively passive ‘implementation by diffusion’ strategy does not lead to uptake in a busy surgical training environment. No matter the potential benefits of any video-based teaching and assessment system, siloed implementation likely breeds inconsistent utilization.