Film Club: A group surgical video review program

Operative video review is important to the growth of surgical trainees, with demonstrated efficacy of one-on-one video-based coaching.¹ While in-the-moment feedback is necessary, asynchronous coaching accompanying video review offers control of learning tempo and cognitive load in a setting without constraints and distractions imposed by the operating room. This allows for meaningful self-reflection, guidance and retained learning. However, barriers to video review are frequently cited that prevent its optimal use. Residents within our general surgery program requested more operative feedback but seldom reviewed their own videos or pursued coaching due to time and effort required.

A monthly, in-person collaborative learning experience in an operative video review program, ‘Film Club’, was created to decrease the burden of video coaching and engage more residents in the practice. The conference benefits from peer learning while remaining under the expert guidance of two attending facilitators/coaches. Program leadership or resident volunteers record operations for the group to review. During each session, one to two operative videos are viewed, with constructive feedback and open discussion from residents and facilitators throughout.

Current engagement in Film Club is high. However, early attendance waned as the novelty of the program wore off. With recommendations from residents, time and location have been changed to those most convenient for them. Leadership has worked to gain buy-in from senior residents, who lead their services and set the tone for allowing and encouraging attendance. We believe these changes stimulated our recent improvement in engagement.

Our first rule of film club was to create a psychologically safe environment. It can be an uncomfortable experience for others to watch one's surgical videos, particularly through the critical lens required of this conference. We have participants sign an agreement that conversation does not leave the room and ground rules are set around constructive language in discussing operative skill and decision making. We made all videos anonymous, but discussions would often lead to questions and comments that could only be addressed by someone familiar with the case. We learned that after our establishment of a safe environment, we were able to progress and make videos identifiable. Our current format first occurred naturally, when the resident operating in the video volunteered background and insight throughout the operation. Coaching for the operating resident and the overall discussion were rich and informed. Residents requested that this change continue. These livelier discussions have also improved meaningful peer learning.

Film Club offers a feasible, efficient group setting for operative video review to impact many learners, who note it as a meaningful, valued educational experience. An indirect benefit of individual residents privately reviewing their own operative videos has been reported, which was a practice not regularly seen before. Residents have commented on the value they now appreciate from the asynchronous, slowed-down, reflective learning and how they have applied their observations to their operative performance. Beyond its direct impact, Film Club may open doors for a changed culture of video review within our program.