Video as an Instructional Media for Technical Operating Room Skills
The technical skills, which include equipment handling, are not the only set of abilities that an operating room staff member needs to train, but they are of extreme importance. In fact, for a long time, technical skills were the only ones that received attention (Graafland, Schraagen, Boermeester, Bemelman, & Schijven, 2014). As a result, there exists a bulk of evidence-based studies that demonstrates the effectiveness of improving operating room staff technical skills with the help of video-based or video-assisted interventions.
For example, Van Det, Meijerink, Hoff, Middel, and Pierie (2013) investigate the INVEST video-enhanced program for surgical procedures training and find that the performance of the participants in the INVEST group was better than that of the more traditional video-devoid education group to a statistically significant extent. Similarly, Buckley, Kavanagh, Traynor, and Neary (2014) discuss sixteen studies that are similar to that of Van Det (2013). Some of these studies involved video-based interventions that comprised, supported or complemented simulations (Buckley et al., 2014, p. 150).
The authors demonstrate that the impact of such training interventions was very positive; the operative time always improved, and other beneficial outcomes related to the participants’ skills were also found. The authors also point out that there are significant limitations to most of the studies, but despite this, the paper by Buckley et al. (2014) demonstrates that video-based and video-involving training interventions for operating rooms staff members are of interest for scientific and practitioner communities due to their effectiveness. However, it is important to mention that in such interventions, videos are typically a part of a program. In other words, watching a video without reflecting on it and participating in other related activities is likely to be less effective than a comprehensive intervention.
Proposal
Problem Statement
While videos are being increasingly used for the training of various skills required from operating room staff (Arriaga et al., 2014; Buckley et al., 2014; Dedy, Bonrath, Ahmed, & Grantcharov, 2016), it is not uncommon for the program facilitators to meet employee resistance in the process (Arriaga et al., 2014, p. 406). The resistance is likely to reduce the effectiveness of the program and can result in absenteeism during sessions, which is why it is a problem that needs to be addressed (Arriaga et al., 2014, p. 403).
Purpose Statement
The purpose of this paper is to provide a plan for the resolution of the problem of operating room staff resistance to the implementation of video-based instructional and educational programs. The attention will be paid to the resistance that originates from the prejudice and the lack of understanding of the benefits of the programs.
Issue Explanation
It is apparent that employee resistance can be caused by different issues. For example, Arriaga et al. (2014) dwell on the problem of employees who are unwilling to dedicate too much time to the program. However, the root of the issue appears to be found not in the amount of time but its perceived waste. In other words, the employees who do not want to waste time on the program are unlikely to believe that it is worthwhile.
Similarly, Buckley et al. (2014) point out that there still exist some concerns about whether video training can be effective (p. 146), which can result in the devaluation of the program and related activities. If employees are prejudiced against video-based programs and perceive them as a waste of time, the effectiveness of the program is likely to decrease and some staff members may refuse to cooperate (Arriaga et al., 2014, p. 403). Therefore, a proper attitude towards video-based programs for operating rooms education needs to be created.
Recommendations for Issue Resolution
The issue of the employees’ prejudice used to be shared by the scientific community (Buckley et al., 2014), which spurred the development of a bulk of evidence-based studies that are devoted to the assessment of various video-based programs. These studies can be reviewed to form a lecture for the employees to learn about the benefits of instructional video-based programs.
The studies typically research a particular set of skills that can be improved via video-based instruction. The technical skills have been examined, for example, by Buckley et al. (2014) who have carried out 16 trials which demonstrate that video-assisted simulations positively affect the operating time and may lead to other outcomes, even though the latter occur less consistently. Similarly, Van Det et al. (2013) discuss a training program titled INVEST that is aimed at the development of technical surgical skills and document a statistically relevant improvement in the intervention group.
Besides, operating room requires strategic problem-solving and decision-making skills. Unfortunately, as pointed out by Graafland, Schraagen, Boermeester, Bemelman, and Schijven (2014), they are underresearched, but there do exist video-based interventions that have been tested for the improvement of individual-level skills in the area (p. 19).
Similarly, Dedy et al. (2016) discuss a nontechnical skills-building program, and their study demonstrates that the intervention was more effective than conventional training without video simulations and several other interventions (group discussions, interactive lectures, and high-fidelity simulations). Another important outcome of instructional videos is the building of communication skills (Arriaga et al., 2014). For example, Korkiakangas, Weldon, Bezemer, and Kneebone (2015) study a program that is aimed at the development of the verbal and non-verbal communication in an operating theater.
The facilitators of the program carry out debriefing to provide an additional possibility for learning; the participants are invited to reflect on the videos as well, which makes the process interactional and offers opportunities for the improvement of the instructional method. Similarly, Arriaga et al. (2014) discuss a complex intervention with video use that focuses on communication skills in operating room and outside of it. The model was used to develop a pilot course, which was attended by 221 operating room members, who provided very positive feedback on the realistic nature of the scenarios and their usefulness for practice.
To sum up, there is a sufficient number of studies that can be used to illustrate the effectiveness of video-based instructions for operating room employees. After that, a program can be carried out at the workplace to proceed to deconstruct prejudice. Also, this solution is likely to result in improved skills, which is a very important bonus.
Video: Educational and Instructional Benefits
Instructional and educational videos and video-involving programs have been proven effective in facilitating and promoting the development of the key sets of skills that are necessary to the operating room staff. Apart from that, such videos have other benefits: they are more illustrative than text, produce the information about situations faster than text, and are typically considered more engaging and motivational by the people who are instructed (Alqahtani, Al-Jewair, AL-Moammar, Albarakati, & ALkofide, 2015).
Also, videos are a safe and accessible way of receiving instruction and training in the skill set of the operating room staff (Buckley et al., 2014). However, they are not typically used on their own. Only video-based or video-assisted programs are considered in research since the proper instruction involves understanding, reviewing, and reflecting on the operating room educational videos. Otherwise, the instruction is likely to be ineffective.
Implementation Plan and Timeline
The primary goal of the proposed solution consists in improving the employees’ understanding of the effectiveness of instructional video programs; the secondary one consists in developing their skills via such a program. To this end, the following objectives are set.
From the literature review, it is apparent that video-assisted instructional programs can serve different purposes, which is why the first step towards the implementation of training consists of assessing the needs of a particular operating room staff. It is the first objective of the plan that should be carried out within a month, even though the timeline is flexible.
The second objective consists in motivating the employees, which is needed throughout the plan implementation. The third objective presupposes the choice of the program, which will be carried out during the assessment month. Since right at the moment the program is unknown, it is impossible to state the timeline for the fourth objective, the implementation of the program.
However, it will include the pre-test assessment of the staff’s skills. Finally, the fifth objective will consist of the post-test assessment, feedback, lessons learned discussion, and results assessment. The intervention will be deemed successful if the primary and secondary goals are achieved. Here, it is important to remember that the goals consist in improving the group’s understanding and skills. The desired level of improvement will be selected for a particular group during the assessment period.
Recommendations for Managing Employee Buy-In
One of the most important parts of the successful implementation of a training program is the engagement of the employees. Also, for this intervention plan, the “buy-in” of the employees is one of the goals. To improve the motivation of the employees, the assessment month should include lectures on the method. The lectures must provide the review of evidence-based research on the topic, which demonstrates the level of effectiveness of the video programs.
It would be best to illustrate both the positive and more controversial aspects; for example, the study of Buckley et al. (2014) shows only one unconditional improvement. The aim of the lectures is to avoid creating unrealistic expectations and to demonstrate the evidence-based and proved effectiveness of the instructional video method.
Other means of motivation also should be provided. Communication with the employees at every step of the implementation program is important. Through communication, the employees can provide ideas for their own motivation. For example, Arriaga et al. (2014) suggest compensating the participants for the time that they spend on the program, providing payment that they would receive for the same amount of working hours. Both monetary and non-monetary means of motivation should be considered together with the specific needs of the employees.
Post-Implementation Assessment
The most effective way to prove that video instruction works consists in demonstrating the employees that the intervention has positive results. Therefore, a pre- and post-test assessment of the employees’ skills is in order. The plan for the assessment should be developed during the needs assessment period; it is supposed to fit the chosen program.
Also, it would not go amiss to plan to gather the employees’ feedback. Depending on the program, it can be collected during, after, or during and after the implementation process. The research shows that instructional video programs are flexible and meant to adapt to a group’s needs (Korkiakangas et al., 2015). As a result, the post-implementation assessment and especially the feedback can be used to improve the selected program.
References
Alqahtani, N., Al-Jewair, T., AL-Moammar, K., Albarakati, S., & ALkofide, E. (2015). Live demonstration versus procedural video: a comparison of two methods for teaching an orthodontic laboratory procedure. BMC Medical Education, 15(1), 1-15.
Arriaga, A., Gawande, A., Raemer, D., Jones, D., Smink, D., & Weinstock, P.,…Berry, W. (2014). Pilot Testing of a Model for Insurer-Driven, Large-Scale Multicenter Simulation Training for Operating Room Teams. Annals of Surgery, 259(3), 403-410. doi:10.1097/sla.0000000000000342
Buckley, C., Kavanagh, D., Traynor, O., & Neary, P. (2014). Is the skillset obtained in surgical simulation transferable to the operating theatre? The American Journal Of Surgery, 207(1), 146-157. doi:10.1016/j.amjsurg.2013.06.017
Dedy, N., Bonrath, E., Ahmed, N., & Grantcharov, T. (2016). Structured Training to Improve Nontechnical Performance of Junior Surgical Residents in the Operating Room. Annals Of Surgery, 263(1), 43-49. doi:10.1097/sla.0000000000001186
Graafland, M., Schraagen, J., Boermeester, M., Bemelman, W., & Schijven, M. (2014). Training situational awareness to reduce surgical errors in the operating room. British Journal Of Surgery, 102(1), 16-23. doi:10.1002/bjs.9643
Korkiakangas, T., Weldon, S., Bezemer, J., & Kneebone, R. (2015). Video-Supported Simulation for Interactions in the Operating Theatre (ViSIOT). Clinical Simulation In Nursing, 11(4), 203-207. doi:10.1016/j.ecns.2015.01.006
Van Det, M., Meijerink, W., Hoff, C., Middel, B., & Pierie, J. (2013). Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training. Surgical Endoscopy, 27(8), 2947-2954. doi:10.1007/s00464-013-2862-2