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Abstract：
In the era of competency-based surgical education, VBC has gained increased attention and may enhance the efficacy of surgical education. The objective of this systematic review was to summarize the existing evidence of video-based coaching (VBC) and compare VBC to traditional master-apprentice-based surgical education.
We performed a systematic review and meta-analysis of randomized controlled trials (RCT) assessing VBC according to the PRISMA and Cochrane guidelines. The MEDLINE, EMBASE, and COCHRANE and Researchgate databases were searched for eligible manuscripts. Standard mean difference (SMD) of performance scoring scales was used to assess the effect of VBC versus traditional training without VBC (control).
Of 627 studies identified, 24 RCTs were eligible and evaluated. The studies included 778 surgical trainees (n = 386 VBC vs. n = 392 control). 13 performance scoring scales were used to assess technical competence; OSATS-GRS was the most common (n = 15). VBC was provided preoperative (n = 11), intraoperative (n = 1), postoperative (n = 10), and perioperative (n = 2). The majority of studies were unstructured, where identified coaching frameworks were PRACTICE (n = 1), GROW (n = 2) and Wisconsin Coaching Framework (n = 1). There was an effect on performance scoring scales in favor of VBC coaching (SMD 0.87, p < 0.001). In subgroup analyses, the residents had a larger relative effect (SMD 1.13; 0.61-1.65, p < 0.001) of VBC compared to medical students (SMD 0.43, 0.06-0.81, p < 0.001). The greatest source of potential bias was absence of blinding of the participants and personnel (n = 20).
Video-based coaching increases technical performance of medical students and surgical residents. There exist significant study and intervention heterogeneity that warrants further exploration, showing the need to structure and standardize video-based coaching tools.
We performed a systematic review and meta-analysis of randomized controlled trials (RCT) assessing VBC according to the PRISMA and Cochrane guidelines. The MEDLINE, EMBASE, and COCHRANE and Researchgate databases were searched for eligible manuscripts. Standard mean difference (SMD) of performance scoring scales was used to assess the effect of VBC versus traditional training without VBC (control).
Of 627 studies identified, 24 RCTs were eligible and evaluated. The studies included 778 surgical trainees (n = 386 VBC vs. n = 392 control). 13 performance scoring scales were used to assess technical competence; OSATS-GRS was the most common (n = 15). VBC was provided preoperative (n = 11), intraoperative (n = 1), postoperative (n = 10), and perioperative (n = 2). The majority of studies were unstructured, where identified coaching frameworks were PRACTICE (n = 1), GROW (n = 2) and Wisconsin Coaching Framework (n = 1). There was an effect on performance scoring scales in favor of VBC coaching (SMD 0.87, p < 0.001). In subgroup analyses, the residents had a larger relative effect (SMD 1.13; 0.61-1.65, p < 0.001) of VBC compared to medical students (SMD 0.43, 0.06-0.81, p < 0.001). The greatest source of potential bias was absence of blinding of the participants and personnel (n = 20).
Video-based coaching increases technical performance of medical students and surgical residents. There exist significant study and intervention heterogeneity that warrants further exploration, showing the need to structure and standardize video-based coaching tools.
摘要：
在基于能力的外科教育时代，VBC已获得越来越多的关注，并可能提高手术教育的疗效。本系统综述的目的是总结基于视频的指导（VBC）的现有证据，并将VBC与传统的基于师徒的外科教育进行比较。
我们根据PRISMA和Cochrane指南对评估VBC的随机对照试验（RCT）进行了系统评价和荟萃分析。MEDLINE,EMBASE,并搜索了COCHRANE和Researchgate数据库以查找合格的手稿。性能评分量表的标准平均差（SMD）用于评估VBC与没有VBC的传统训练（对照）的效果。
在确定的627项研究中，24项随机对照试验合格并进行了评估。研究包括778名手术学员(n=386例VBC与n=392对照)。13项绩效评分量表用于评估技术能力；OSATS-GRS是最常见的（n=15）。术前提供VBC（n=11），术中（n=1），术后（n=10），围手术期（n=2）。大多数研究都是非结构化的，其中确定的教练框架是实践(n=1)，增长(n=2)和威斯康星州教练框架(n=1)。对性能评分量表的影响有利于VBC教练（SMD0.87，p<0.001）。在亚组分析中，与医学生（SMD0.43，0.06-0.81，p<0.001）相比，居民对VBC的相对影响更大（SMD1.13;0.61-1.65，p<0.001）。潜在偏见的最大来源是参与者和人员没有失明（n=20）。
基于视频的辅导提高了医学生和外科住院医师的技术表现。存在重要的研究和干预异质性，值得进一步探索，显示需要构建和标准化基于视频的教练工具。
我们根据PRISMA和Cochrane指南对评估VBC的随机对照试验（RCT）进行了系统评价和荟萃分析。MEDLINE,EMBASE,并搜索了COCHRANE和Researchgate数据库以查找合格的手稿。性能评分量表的标准平均差（SMD）用于评估VBC与没有VBC的传统训练（对照）的效果。
在确定的627项研究中，24项随机对照试验合格并进行了评估。研究包括778名手术学员(n=386例VBC与n=392对照)。13项绩效评分量表用于评估技术能力；OSATS-GRS是最常见的（n=15）。术前提供VBC（n=11），术中（n=1），术后（n=10），围手术期（n=2）。大多数研究都是非结构化的，其中确定的教练框架是实践(n=1)，增长(n=2)和威斯康星州教练框架(n=1)。对性能评分量表的影响有利于VBC教练（SMD0.87，p<0.001）。在亚组分析中，与医学生（SMD0.43，0.06-0.81，p<0.001）相比，居民对VBC的相对影响更大（SMD1.13;0.61-1.65，p<0.001）。潜在偏见的最大来源是参与者和人员没有失明（n=20）。
基于视频的辅导提高了医学生和外科住院医师的技术表现。存在重要的研究和干预异质性，值得进一步探索，显示需要构建和标准化基于视频的教练工具。
