BACKGROUND 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. METHODS 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). RESULTS 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). CONCLUSION 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.

中文翻译：

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外科教育中基于视频的教练：系统的回顾和荟萃分析。

背景技术在基于胜任力的外科教育的时代，VBC已经得到越来越多的关注，并可以提高外科教育的功效。这项系统评价的目的是总结基于视频的辅导（VBC）的现有证据，并将VBC与传统的基于主学徒的外科手术教育进行比较。方法我们根据PRISMA和Cochrane指南对评估VBC的随机对照试验（RCT）进行了系统的回顾和荟萃分析。在MEDLINE，EMBASE，COCHRANE和Researchgate数据库中搜索了合格的手稿。绩效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。结果在627项研究中，有24项RCT符合条件并进行了评估。这项研究包括778名外科手术学员（n = 386 VBC vs. n = 392对照）。使用13个绩效评分量表来评估技术能力；OSATS-GRS是最常见的（n = 15）。术前（n = 11），术中（n = 1），术后（n = 10）和围手术期（n = 2）提供VBC。大多数研究都是非结构化的，其中确定的指导框架为PRACTICE（n = 1），GROW（n = 2）和Wisconsin Coaching Framework（n = 1）。有利于VBC指导的绩效评分标准受到影响（SMD 0.87，p <0.001）。在亚组分析中，与医学生（SMD 0.43，0.06-0.81，p <0.001）相比，居民对VBC的相对影响更大（SMD 1.13; 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）。结论基于视频的教练提高了医学生和外科住院医师的技术水平。存在大量的研究和干预异质性，需要进行进一步的研究，这表明需要构建和标准化基于视频的教练工具。