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ES 远程监考在外科培训中的兴起
The following case report dives into the advantages of teleproctoring for both mentors and mentees in the context of surgical training. For Dr. De Vos, navigating her first solo procedure under remote supervision accelerated her learning and strengthened her independence. The lack of an onsite proctor pushed her to resolve challenges independently, enhancing her decision-making abilities and leadership within the OR. On the mentor side, Prof. Dr. Oosterlinck experienced significant time and resource savings, highlighting the efficiency and environmental benefits of teleproctoring by eliminating the need for travel.
未来的挑战
Dr. Marie De Vos is a cardiac surgeon in her fourth year of residency ready to transition from a supporting role to a leading one in the operating room.
在过去两年中，她在 Wouter Oosterlinck 教授的专业指导下掌握了微创冠状动脉手术，在首次单独手术中，她选择了远程指导，从而拥抱了数字前沿。
Operating out of general hospital AZ Sint-Jan Brugge, Bruges, Belgium, Dr. De Vos prepared to undertake the procedure with the digital remote support of Prof. Dr. Oosterlinck, who would be proctoring from Leuven, roughly a 2,5-hour car drive away. This arrangement promised to blend the autonomy necessary for Dr. De Vos’ growth with the safety net of expert supervision.
确定远程准备就绪的时间
The journey from observer to practitioner in the field of surgery is multifaceted and varies for each individual. The consensus between the resident surgeon and her mentor, highlights a critical aspect of transitioning to teleproctoring: the readiness of the surgeon. “It’s essential that you’ve been part of the procedure extensively,” Dr. De Vos explained. “The decision to start teleproctoring is a collaborative one between the proctor and the surgeon. In my case, I felt prepared for remote support, and Prof. Dr. Oosterlinck agreed.”
Dr. De Vos’ 2 year preparation included three months of meticulous observation, attending procedures at least twice per week, followed by another three months of intensive training where she actively participated in various aspects of the surgery. This progressive approach built her confidence and skill set.
Prof. Dr. Oosterlinck, endorsing his mentee’s readiness, stated, “She successfully completed every step, and together, we chose a straightforward patient for her first solo procedure” —a decision that was as strategic as it was pedagogical.
Now it was about connecting all these individual steps into one fluid operation. They opted for a case that demanded a high level of technical skill and mental fortitude, especially for a surgeon’s first solo procedure.
远程连接
For Dr. De Vos’ solo procedure, the Rods&Cones Remote Collaboration Service served as the digital bridge between her and her Proctor. During the mammary harvesting phase of the procedure, the robot’s video feed was shared with Prof. Dr. Oosterlinck and during the open anastomosis phase of the operation, she wore smart glasses that offered her proctor a first-person perspective of the surgical field.
From his office in Leuven, the Professor was virtually present in the operating room in Bruges via his computer screen. This setup enabled him to observe and follow the procedure with the same level of detail as if he were physically present.
Reflecting on the experience, Dr. De Vos noted the unobtrusiveness of the smart glasses. “The camera didn’t interfere with my work and the audio quality was excellent—I could hear Prof. Dr. Oosterlinck clearly,” she said. The seamless integration of the technology into her surgical process showcased its ability to enhance the procedure without causing distractions or discomfort.
学员的优势--培养独立和决策能力
远程监考在指导与独立之间取得了微妙的平衡，为外科培训提供了独特的优势，这反过来又为玛丽-德沃斯医生这样的受训人员提供了更清晰的学习曲线。学员必须在没有监考老师在场的情况下解决问题，这就培养了学员的自主意识和批判性思维。
The surgical practitioner experienced this firsthand, the absence of the proctor in the room compelled her to rely on her skills and judgment to complete the procedure. “It was more effective remotely, as this way, I had to finish the procedure myself. It gives me more time to find solutions to problems before seeking assistance”.
The absence of the proctor’s physical presence also ensures that the trainee maintains the leading role in the operating room, reducing distractions. Prof. Dr. Oosterlinck acknowledged the benefits of this approach. “There should be only one operating surgeon. If somebody else is giving orders, it is distracting for the team. It is the safest approach,” he said. Proctoring remotely, the proctor guides and supports without overshadowing the surgeon’s authority.
远程监考通过创造和促进受训外科医生必须果断行动并对手术负全责的情景，加快了受训者的发展。这种方法可确保受训者最终在没有监考的情况下进行手术时，能够做好充分准备，在手术室中扮演自信、干练的领导者角色。
Proctor 视角--通过数字化手段加强导师制
Prof. Dr. Oosterlinck expressed a high level of satisfaction with the process: “I was very positive about the steps we took. The interventions and guidance helped to identify problems and find solutions. It underlines that our physical presence is not necessary to achieve these outcomes.”
For the experienced cardiologist, successful teleproctoring hinges on the preparation of the trainee and the quality of digital communication tools. “If the trainee is well-prepared, physical presence is not required. What’s essential is the ability to communicate, solve problems, and provide intellectual and mental support digitally. The tools we used met these needs exceptionally well.”
Another significant benefit for the proctor is the considerable saving of time and resources. He compared the logistics of in-person proctoring with the teleproctoring session. “I logged in at about 9:00 and was done by 1:00. In contrast, an in-person visit would require leaving home around 6 and not returning until between 3 and 4, not to mention the unpredictability of traffic.
距离越远，不确定性和时间投入就越大。如果考虑到国际距离，时间和成本，包括对环境的影响，都会成倍增加"。
"在评估我参与过的所有监考案例中，有很大一部分都可以进行远程管理，"他建议说。"对于具有冠状动脉背景并接受过适当模拟训练的专业人员来说，我相信经过一到两次实际访问后，团队就可以在数字支持方面取得进展了"。
Oosterlinck envisions a functional model involving one-third physical presence and two-thirds remote assistance. “I am convinced of this approach.”
Reflecting on the time spent traveling for in-person proctoring, the Professor often questions the necessity of his physical presence. The effort of being on-site, the eight-hour travels, the planes, the traffic—it all comes into question when he finds himself simply offering support from the sidelines, a role that, as demonstrated with Dr. De Vos, can effectively be fulfilled from a distance. The ability to identify issues, ask the right questions, and provide solutions does not always require being physically present in the operating room. The Session with Dr. De Vos made it clear to him, that remote teleproctoring is not just a viable option but also a potentially superior one in certain contexts.
这种具有成本效益的方法不仅能减轻经济负担，还能最大限度地减少与旅行相关的碳足迹，符合人们日益增长的环保意识。
Moreover, trainees like Dr. De Vos benefit from this model, gaining independence more quickly, thereby diminishing the need for constant proctor presence. “Dr. De Vos is already taking off after this session. With support for maybe three or four more cases, she’ll be ready to proceed independently. And I anticipate that within a year, she’ll be tackling more complex cases, potentially requesting my digital presence as a safety net,” Prof. Dr. Oosterlinck projected.