Technology


accessible and well organised work instructions for operating theatre staff, new hires, locum and agency staff. He points out that new and ‘transient’ members of staff need to be ‘on boarded’ or better (i.e. trained during orientation or the induction period). They may not be used to working with the surgeon and this where technology could have a significant impact.


E-learning and video-based training Incision has developed a rapidly growing e-learning platform (Incision Academy) featuring around 700 accredited courses, aimed at providing education and training to prepare for the operating room. The technology includes video-based modules, interactive 3D anatomy, essential peri- and intra- operative information, test certification, and competence tracking, to support all levels of interdisciplinary training – helping to ensure the operating department is as safe and efficient as possible. The platform can help theatre staff to better understand, identify and mitigate potential hazards. Furthermore, the ability to project anatomy onto the procedure itself – using augmented reality and 3D modelling – can help staff fully understand the structures, medical devices that will be used, and steps of the procedure. Furthermore, the technology can also be used to optimise and standardise procedures. “If everyone works the same way, operating


theatres can become much more efficient,” Pallandt points out. The technology provides a useful educational


tool for a variety of professional roles within the theatre. However, one area where it has been shown to have a particular impact is in supporting surgical trainees, scrub nurses and ODP students during their training. Research by Selten et al (2022) investigated the effects of a video-based platform (in addition to the standard curriculum), on medical students’ self-reported and tested surgical knowledge, for example.5


The study included


fourth-year students undertaking training at the Erasmus University Medical Center (Erasmus MC), Rotterdam, The Netherlands, and across 11


affiliated general hospitals. Ninety students followed the usual surgical curriculum (control group), followed by 88 students who were given voluntary access to a video-based surgical educational platform – i.e. Incision Academy (video group). Students in the video group indicated that they had better resources at their disposal than the control group for surgical procedures (p = 0.001). Furthermore, students in the video group


showed a greater increase in self-reported surgical knowledge (p = 0.03) and in more objectively tested surgical knowledge (p < 0.001). The researchers concluded that the educational platform “improved test scores and self- reported surgical knowledge”, while students felt “better prepared” and more able to find the information they required. How video content is presented is also important, however. Nazari et al (2020) conducted a study to compare the effects of cognitive load and surgical performance in medical students that performed open inguinal hernia repair, after preparation with step-by- step video-demonstration versus continuous video-demonstration.6


In this prospective


study, participants were randomly assigned to the step-by-step or continuous video- demonstration. They completed questionnaires regarding perceived cognitive load during preparation and their surgical performance was assessed on a simulation hernia model. Forty-three students participated – 23


Digital support makes it easy to compare ways of working and to start a discussion about why you do things differently – to learn from each other. We see teams working together in a more synchronised way, which is a step towards increased efficiency. Charles Pallandt, chief commercial officer, Incision


students in the step-by-step group and 20 in the continuous group. The step-by-step group perceived a lower extraneous cognitive load (2.92 ± 1.21) compared to the continuous group (3.91 ± 1.67, p = 0.030). The surgical performance was not statistically significantly different between both groups. However, in sub-analyses on a selection of students that prepared for 1 to 2 hours, the step-by-step group made fewer procedural errors (1.67 ± 1.11), compared to the continuous group (3.06 ± 1.91, p = 0.018). The researchers concluded that preparation


using step-by-step video-based learning “results in lower extraneous cognitive load and subsequently fewer procedural errors during the surgical performance. For learning purposes, demonstration videos of surgical procedures should be presented in a segmented format.”


A ‘digital assistant’ While ‘off-the-job’ preparation is important, staff also need support while preparing for theatre lists on the day – including setting up the operating theatre, working with the surgeon and working as a member of the team. Incision Assist provides the surgical team with a unified view of the requirements and preferences to support staff through any procedure. The ‘digital assistant’ includes all the information required for successful operating theatre performance, with access to an extensive library of different procedures. For each type of procedure, the App provides easy-to-follow information on operating theatre setup, patient preparation and positioning, disposables, instruments, implants, draping, surgical steps, and post-operative instructions. With all the people, setups and instructions related to a procedure in one place, efficiency can be improved. “Potential delays can be avoided by ensuring staff can quickly identify any medical device error codes; they know how to position the patient in the right way; and they understand how to apply the draping for a specific procedure. A 30-60 second animation or 3D image can solve issues


April 2023 I www.clinicalservicesjournal.com 25


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