Rana M. Higgins

Background The transition from medical student to surgical resident involves a significant shift in responsibility, learning style, and hands-on training complexity. Navigating all these professional hurdles can be a challenge, and residents may struggle with various aspects of these throughout their training, which can lead to the need for remediation. Residency programs must facilitate efforts to identify and address both technical and non-technical deficiencies through targeted remediation. Materials and methods Members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Resident and Fellow Task Force (RAFT) Committee performed a review of technical and non-technical components of resident remediation. Results The two primary components of remediation in a residency program are technical and non-technical skill competencies. The role of the program director is essential to guiding and facilitating the remediation process for residents. Additionally, efforts to prevent remediation are important to implement within a residency program’s structure. Current resources focus on technical and non-technical skills remediation. Program design and video-based assessments play crucial roles in technical skills remediation. For non-technical skills remediation, these address resident deficiencies in professionalism, interpersonal skills and communication. Conclusion Resident remediation is a complex yet essential responsibility for surgical training programs. It requires structured strategies tailored to both technical and non-technical skills, grounded in timely identification and consistent support. Effective remediation begins with early recognition of deficits and the development of clear, personalized improvement plans. These plans must outline specific goals, measurable outcomes, and mechanisms for progress assessment.

Surgery has become increasingly subspecialized and complex and therefore teaching strategies for surgical trainees must also adapt. Operative video review and coaching represents a potential innovation to improve the efficacy of resident skill acquisition. Effective implementation of any video-based program includes the creation of a video-based culture through a cycle of incentivization that focuses on record, store, apply, and champion. Record involves identifying institutional requirements and capabilities and understanding the nuances of capturing videos for both open and minimally invasive operative cases. Store highlights the importance of transitioning recorded videos from OR devices to personal devices, including external drives and cloud-based systems. Apply is a crucial step in that recording and storing the videos are only useful if application is emphasized. Video-based coaching as well as video review and competency-based education are applications of video-based assessments that can have a significant impact on educational quality improvement. Additionally, operative videos can be applied toward video abstracts and presentations, as well as gamification in training programs, optimizing resident engagement and educational interest. Finally, champions of video-based assessments are important for implementation and dissemination of a video-based culture. As educators and learners, we should embrace and promote video-based assessments and begin to see this as an integral part of surgical education, lifelong performance improvement, and continuous certification.