Simultaneous Remote Laparoscopic Training for Trainees Among Multiple Institutions: Can Remote Coaching Replace On-Site Coaching?

Introduction: Regional disparities in medical practice between urban and rural areas in Japan represent a critical issue, and extend to the field of surgical education. To address these disparities, we evaluated the effectiveness of simultaneous remote coaching across multiple facilities using a standardized laparoscopic training method.

Methods: A total of 28 trainees from a university hospital and 3 rural hospitals were categorized into remote and on-site coaching groups. The training curriculum included lectures, practical training, and assessments, conducted for 1 h per week using three sessions. The primary endpoint of the study was the change in time for ligation of one suture between the on-site and remote coaching groups, expressed as the median of the reduction suture time rate (RTR). Secondary endpoints included the RTR categorized by years of graduation and the results of a questionnaire survey of participants.

Results: Participants included 19 trainees in postgraduate year (PGY) 1-2 and 9 those in PGY 3-5. The median suture ligation time for the first attempt was 145 s (remote: 136 s vs. on-site: 160 s; p = 0.33) and that for the third attempt was 51 s (remote: 33 s vs. direct: 52 s; p = 0.91). The median RTR was 57%, with no significant difference observed between the remote and on-site coaching groups (43.2% vs. 71.2%, p = 0.26). The trainees' ratings for the training were generally favorable, with median ratings of 4 (range: 3-5) for the content of practical skills and 5 (4, 5) for the distance learning aspect, based on a 5-point Likert scale.

Conclusion: Simultaneous remote laparoscopic training could be effective in reducing disparities in surgical education.