LappClinic: Unveiling the Impact of Residents’ Surgical Video Analysis and Simulation Training on Skill Development in Laparoscopic Cholecystectomy – A National Multi-Center Study

Background Quality feedback is essential to surgical learning. Simulation training accelerates skill acquisition, and video-based assessment (VBA) offers proven educational benefits. However, evidence of their combined effect in real surgical cases is limited. We conducted a multi-center intervention integrating VBA and remote-asynchronous feedback for real laparoscopic cholecystectomies (LC) and the completion of an Advanced Laparoscopy Course (ALC). Users experience, and an analysis of objective performance outcomes was performed. Methods Seven general-surgery residency programs in Chile participated (2022-2025). Residents uploaded LC videos to the LAPPCLINIC platform and were randomized to receive either assessment-only or assessment + asynchronous expert feedback. Perceptions were evaluated through an online survey and focus group. Videos were assessed using OSATS and OPRS. ALC status was registered. The primary outcome was achievement of OSATS ≥20. Mixed-effects logistic regression adjusted for ALC status, feedback arm, cumulative case number, and surgical difficulty. Results Of 142 invited residents, 51 (35.9%) participated, uploading 455 videos (436 eligible). Twenty-eight residents completed the survey: 96% desired additional feedback beyond the OR. Platform feedback was rated higher than OR feedback (6.2 vs 5.25/7, P = .0065). ALC completion was independently associated with higher odds of OSATS ≥20 (OR 4.69; 95% CI 1.53-14.4; P = .0069). Feedback allocation was not significant (OR 0.40; 95% CI 0.15-1.08; P = .070). Conclusions Residents rated asynchronous feedback higher than conventional OR feedback. Completion of the ALC correlated with objectively higher surgical performance, supporting the integration of structured simulation and video-based coaching within residency curricula.