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Comment & Response
February 8, 2017

Wearable Recording Devices for Surgical Training

Author Affiliations
  • 1Department of Anaesthesia, the ASSERT Centre, University College Cork, Ireland
  • 2Departments of Neonatology and Paediatrics and of Child Health, Cork University Maternity Hospital, University College Cork, Cork, Ireland
  • 3Department of Anesthesia, Adelaide and Meath Hospital, Tallaght, Dublin, Ireland
JAMA Surg. Published online February 8, 2017. doi:10.1001/jamasurg.2016.5657

To the Editor Beard et al1 have described their use of wearable cameras to augment training of surgical residents by creating a “point-of-view surgical education library.” Their clearly articulated argument for such use is convincing, innovative, and achievable in a health care setting. We suggest that one critical aspect of the practice of using wearable recording devices for procedural training in medicine has been overlooked or understated. A “metrics-driven” approach to surgical training has consistently been shown to be effective in decreasing errors and improving efficiency in both the simulated and clinical environment.24 These performance metrics and errors are observable behaviors, most or all of which can be captured by first-person point-of-view videos. Metrics are the fundamental materials on which deliberate practice, feedback, and assessment are based. In effect, the first-person surgical video is an invaluable training resource when viewed as a digital data set that is best interpreted through the filter of unambiguously defined metrics. Over the past 3 years, our experience in enabling trainees to use wearable recording devices in clinical settings (eg, peripheral nerve blockade,5 epidural anesthesia, neonatal tracheal intubation, and peripherally inserted central catheter) has reaffirmed the value of combining 2 complementary innovations (namely, metrics-based training and wearable recording devices). One facilitates acquisition, the other interpretation and exploitation of critical visual data.

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