Backgrounds: COVID-19 related reduction of surgical procedures jeopardizes learning on the job of surgical residents. Many educators resorted to digital resources in the search for alternatives. However, these resources are often limited to the extent they offer resident-surgeon interaction like a joint surgical performance does. Here we present a roadmap of livestreaming surgical procedures, and evaluate how surgical livestreams on human cadavers address the unmet educational needs of surgical residents in our Dutch nationwide initiative. Methods: Technical and organizational feasibility, and definition of outcome deliverables for the livestream series and per livestream were essential in livestream development. Faculty selected interventions, lecture contents, and participant preparations. Appropriate location, technical setup, and support were imperative for a stable, high-quality stream with integrated interaction, while maintaining digital privacy. A survey was sent to livestream participants to evaluate each livestream, and allow for constant improvement during the broadcasting of the series. Only surveys which were completed by surgical residents were included in the analysis of this study. Results: Each livestream attracted 139–347 unique viewers and a total of 307 surveys were completed by participants (response rate of 23–38% per livestream). Sixty percent of surveys (n = 185) were completed by surgical residents. Livestreams were highly valued (appreciation 7.7 ± 1.1 and recommendation 8.6 ± 1.1), especially the live procedures combined with interaction and theoretical backgrounds. Criticized were technical difficulties and timing of the livestreams between 5 and 7 pm, which interfered with clinical duties. Conclusion: Livestreaming surgical procedures on human cadavers is a valid and valued solution to augment resident education. Digital privacy and a stable, high-quality interactive stream are essential, as are appropriate moderation and relevant lectures. While livestreaming cannot replace hands-on training in the operating room, it enables surgeon-resident interaction which is key in education—and missed in pre-recorded surgical procedures which are currently available online.
Bibliographical noteFunding Information:
The authors declare that the following persons are co-authors who participated through the NVvH livestream collaboration group on this study and accept direct responsibility for the manuscript: Jerry Middelberg, Ilona Veenema, Goos Huijzer, KlaasWalter Meyer, KerriLee Colman, Esther Jacobs, Olivier R. C. Busch, Jeroen Hagendoorn, Rutger-Jan Swijnenburg, Hilko A. Swank, J. Sven D. Mieog, Bas Groot Koerkamp, Michiel H. J. Verhofstad, Johan G. H. van den Brand, Martin J. Heetveld, Floortje Huizing, Sven A. G. Meylaerts, Jan-Willem H. P. Lardenoije, Jaap F. Hamming, Joris J. Blok, Marlies J. Keijzers, Jan Willem H. C. Daemen, Schelto Kruijff, Tessa M. van Ginhoven, Lutske Lodewijk, Yvonne L. J. Vissers, Geertruid Marres, Koen J. Hartemink, Wout B. Barendregt, J. Wolter A. Oosterhuis, Merlijn Hutteman, Donald van der Peet Affiliations Jerry Middelberg, Ilona Veenema, Goos Huijzer, Klaas Walter Meyer, Kerri Lee Colman: Amsterdam Skills Centre (ASC), Amsterdam, The Netherlands Esther Jacobs: Nederlandse Vereniging voor Heelkunde (NVvH), Domus Medica, Utrecht, The Netherlands Olivier R.C. Busch, Rutger-Jan Swijnenburg, Hilko A. Swank, Donald van der Peet: Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, The Netherlands Jeroen Hagendoorn: Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands J. Sven D. Mieog, Jaap F. Hamming, Joris J. Blok: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands. Merlijn Hutteman: Department of Surgery & department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands, Bas Groot Koerkamp, Tessa M. van Ginhoven: Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands Michiel H.J. Verhofstad: Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, PO-box 2040, 3000 CA Rotterdam, The Netherlands Johan G.H. van den Brand: Department of Surgery, Northwest Clinics, Alkmaar, The Netherlands Martin J. Heetveld: Department of Surgery, Spaarne Gasthuis, Haarlem, The Netherlands Floortje Huizing, Sven A.G. Meylaerts, J. Wolter A. Oosterhuis: Department of Surgery, Haaglanden Medical Centre, Den Haag, The Netherlands Jan-Willem H.P. Lardenoije: Department of Sugery, Rijnstate Hospital, Arnhem, The Netherlands Marlies J. Keijzers, Jan Willem H.C. Daemen: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands Schelto Kruijff: Department of Surgery, University Medical Center Groningen, The Netherlands Lutske Lodewijk: Department of Surgery, Diakonessen Hospital, Utrecht, The Netherlands Yvonne L.J. Vissers: Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands Geertruid Marres: Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands Koen J. Hartemink: Department Surgery, the Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands Wout B. Barendregt: Department of Surgery, Canisius-Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
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