Incorporate quality control measures with standardized photographic or video-based assessments using predefined anatomic landmarks¶

Strategy · All strategies
Evidence · no claims cited

Description¶

The review recommends incorporating quality control measures such as standardized photographic or video-based assessments employing predefined anatomic landmarks to ensure consistent and objective validation of surgical technique during learning curve assessment. This addresses the finding that none of the included studies described the use of intraoperative or postoperative audit protocols to verify the completeness of the dissection, unlike the JCOG0212 trial which employed photographic verification.

Design Implications¶

Context¶

Requirements¶

• Predefined anatomic landmarks for assessment

Constraints¶

Target Learners¶

• Surgical trainees learning LLND

Target Learning Goals¶

• Standardizing surgical technique assessment in LLND training

Related Strategies¶

• Use risk-adjusted cumulative sum (RA-CUSUM) analysis to account for case-mix heterogeneity in learning curve assessment
• Incorporate objective structured scoring systems and progressive dashboards into self-directed curricula to support motivation and autonomy development
• Adopt cluster-randomised or stepped-wedge trial designs with blinded, video-based assessment and pre-defined process and patient endpoints in future NTS training research.

Examples¶

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Key Sources¶

• Kehagias D., Baldari L., Cassinotti E., Boni L., Lampropoulos C., Kehagias I. (2025). Learning curve for lateral lymph node dissection in rectal cancer – a systematic review of literature. Techniques in Coloproctology. https://doi.org/10.1007/s10151-025-03214-3