Introduction

Because surgical skill may be a determinant of patient outcomes, there is growing interest by practicing surgeons in improving their own technical skills. In the Michigan Urological Surgery Improvement Collaborative (MUSIC), we assessed the feasibility of a peer video review workshop for surgeons performing robot-assisted radical prostatectomy (RARP). _x000D_

Methods

MUSIC urologists were invited to submit representative videos of a nerve-sparing RARP which were edited into videos of the anastomosis and nerve-sparing parts. All videos were reviewed by 56 peer surgeons for global, and procedure-specific, skill using validated instruments. Surgeons completed a Kolb Learning Style Inventory and were categorized into one of four learning styles: Converger, Diverger, Accomodator, or Assimilator. Surgeons were then paired based on peer ratings for skill and learning type. Optimal pairings are convergers/divergers and accommodators/assimilators (Kolb, 1984). At the workshop, paired surgeons reviewed each participant's videos for 60 minutes, using a structured template. At the end of the workshop, surgeons completed a survey evaluating the activity. _x000D_

Results

The peer review workshop involved 24 surgeons. Videos were reviewed using a step-wise schema of (1) equipment, (2) set-up, (3) approach, (4) execution strategy, (5) evolution of technique, (6) lessons learned, and (7) difficult scenarios. Learning style for surgeons consisted of convergers (42%), assimilators (33%), accommodators (17%) and divergers (8%). The survey was completed by 96% of participants. Nearly all (96%) participants felt the workshop increased their self-awareness for improvement, helped identify changes to technique they could implement, and was an effective learning experience (Table). All but one surgeon expressed a desire to participate in another workshop; this surgeon was incorrectly paired for learning style (converger + accommodator). _x000D_

Conclusions

Peer video review workshop for practicing surgeons performing RARP is feasible and appears to help surgeons identify technical skill improvement opportunities. Our work highlights the importance of matching surgeons with compatible learning styles. Future work will assess if video review improves technical skill and patient outcomes. _x000D_

Funding

Blue Cross and Blue Shield of Michigan _x000D_