Ignacio Avellino

All along their careers, surgeons learn through mentoring, operating on patients side-by-side with expert surgeons. However, access to experts is more and more challenging as they are often located far from learners. Telementoring can increase the reach of mentors by supporting mentoring at a distance, but despite their potential, current systems remain rarely institutionalized. We investigate current surgical mentoring practices, to inform future design of telementoring systems in providing support for learning. In a field study, we observe 11 surgeries and conduct follow-up self-confrontation interviews with mentor-mentee pairs. Through Thematic Analysis, we find that the domain of surgery results in mentee's needs for reassurance regarding safety, being spared from workload and risk, both essential to support the acquisition of skills. Second, that mentors understand the situation primarily through the surgical site view but also through inspecting the mentee's posture and the patient's body. Thirdly, that mentors take physical distance as their presence limits mentees' autonomy development. We discuss the limits of current surgical telementoring systems and rethink their role as companions of onsite mentoring.

Videos are a powerful media to learn activities through guided physical training such as surgery, especially when they are produced following human learning models and not as "how-to" videos. However, their success greatly depends on how they are integrated into the extensive curricula of domains where learning occurs through guided practice. In this work, we investigate the impact of integrating video as a learning tool into the learning curricula of surgery. We created a pedagogical video on surgical hysterectomy through a model based on the Conceptual Fields theory (Vergnaud) and performed two rounds of interviews with seven medical residents, who watched the video freely during their residency in gynecology-obstetrics as they trained with experts. We find that videos can complement guided physical training, as they can provide the rationale behind expert action, something that is difficult to explicit during guided training. Still, their linear and static nature limits their integration as true adjuncts. We discuss our vision of moving towards interactive videos created with an ontological approach, developed in a workshop with four expert surgeons, which involves the ability to navigate through levels of information and layers of representations, so that experts can represent information to learners according to pedagogical models that complement their complex and extensive learning curricula.