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Comment & Response
February 8, 2017

Wearable Recording Devices for Surgical Training—Reply

Author Affiliations
  • 1Department of Orthopedic Surgery, Tufts Medical Center, Boston, Massachusetts
  • 2Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina
  • 3Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
JAMA Surg. Published online February 8, 2017. doi:10.1001/jamasurg.2016.5658

In Reply We wish to thank Shorten and colleagues for their insightful letter on our article, which describes the creation of an institution-specific surgical video library using consumer-grade wearable cameras.1 They cite several valuable references that strive to modernize medical education—virtual-reality modules, hands-on simulators, and metric-based proficiency. We initially hoped that our project would provide the foundation for a proficiency-based curriculum, especially with the recent emphasis on surgical skill milestones espoused by the Accreditation Council for Graduate Medical Education.2 We called this the “game-day footage model”—a resident would film his or her performance during surgery and then review the video either alone or with the attending surgeon offering feedback. Unfortunately, with this phase of our project, we encountered challenges. First, a small pilot project intended to assess the noninferiority of video-based instructions compared with written instructions was unrealistic to power owing to the limited number of trainees at our institution. Second, a busy surgical schedule rarely allows for the routine review of footage. After performing several surgical procedures, it is difficult to find time to then watch each procedure again at the end of the day. The references listed by Shorten et al discuss the use of video-based performance feedback in surgical simulators and the use of shorter anesthetic procedures, both of which are more feasible than reviewing entire surgical procedures. The outcome of our project, an affordable, institution-specific, high-yield surgical video library, represents a practical tool for training residents.

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