Video training in open trauma: A program for the development of surgical skills in trauma | BMC medical training

Goal

This descriptive study aims to emphasize the innovative use of hand camera devices to improve surgical training in a single trauma center in South America.

equipment

Recording devices for trauma surgical processes include both hand-action cameras and intelligent glasses. A GoPro Hero4 camera in a waterproof housing is used as a primary camera to avoid damage. The case is able to sterilize rapid ethylene oxide sterilization between the cases (Fig. 1). Instead of the waterproof housing, a sterile glove or ultrasound probing cover can be used, although poorer image quality can be expected. In addition to the GoPro4 handheld, we usually use a firm camera mounted with a head like the Pivothead Durango Dua85a0230. Finally, the primary operating surgeon can wear a camera system mounted with a Googleglass-Kopf that delivers images from the perspective of the main surgeon. In general, head cameras should be considered if the video recording requires several angles or several surgical websites. The procurement and maintenance of devices and the associated technology were fully financed and supported by the personal resources of the surgeons invested in this work.

Recording and workflow

The recording devices are located in a certain location in the trauma bay and are called up by the medical student or junior resident before the operation case. The medical student or the year based in the first year gives the case to get high -quality images of the procedure. The primary cameraman is instructed before entering the operating room when using the camera properly. We have found that the responsibility to a junior member member optimizes the efforts, the core operating team can concentrate on the safety of the patients and the technical aspects of the operation and convey a meaning and commitment to medical students. The operating experience from the trainee always has priority before the video recording. Junior operational residents and medical students are only assigned to video record tasks if they would not otherwise help directly with the operation. As a result, the video program in our institution did not affect practical surgical training. When initiating a trauma video workflow, the surgeons should consider how many and the trainee's departments are usually available in these rare cases and assign the tasks accordingly. After the recording, the video is downloaded immediately after the case to a designated encrypted laptop. The video is edited to remove identifiable patient information and unwanted video content. Often the processing surgeon or another educator can contain specific audio content (ie voice-over) during the processing process in order to emphasize critical steps of the procedure. As a rule, editing, voice-over and the final preparation of a single case video takes 45 minutes to a few hours, but this varies significantly depending on the length and complexity of the case.

Sotero del Rio has also added video recordings on its standard hospital recording form. In view of the development of trauma procedures, the team enables the team to focus on preparing for the operational procedure instead of the video declaration process. During the postoperative period, the patient's consent or approval is expressly obtained by a suitable health representative before storing the video library. It is important that all videos with all patients with patients, tattoos, etc. are not identified that are triggered or removed during the editorial process. Patients have no access to these videos. The approval form signed by patients states that all images taken are used exclusively for educational purposes. This routine consent procedure limits the likelihood of video content that leads to legal steps. Although we had no important obstacles with the data protection office of our hospital for the internal use of video recordings for education, the broader spread of our repository via public streaming platform (such as YouTube or Vimeo) would require a more extensive approval process. Surgeons and educators who are interested in the introduction of similar video libraries should consult the legal office of their institution and understand all local legal requirements. In addition, the approval of a formal declaration of consent and a video repository distribution plan with the corresponding institutional data protection office should be pursued to initiate a trauma video program to prevent long delays.

Results

According to our knowledge, this is the largest high-quality video repository of emerging trauma cases. Since 2017 we have recorded over 1000 hours of video with over 250 independent operations and trauma playback. The video content included over 100 cases of cardiac, thoracic and lung lesions, 9 cases of pancreatic trauma and 18 cases of peripheral vascular diseases. Trauma videos that were collected in Sotero del Rio was used in morbidity and mortality meetings, in educational content for surgical residents and medical students and in direct review by visitors to surgeons to improve self-improvement (Fig. 2). Further videos of a traumatic operation for Obere Vena Cava injuries can be found under additional file 1 for an example video.

((A) Video recording with GoPro in the sterile case. ((B) Use of dream videos at an interactive clinical meeting