In this prospective cross-sectional study, we designed, delivered, and evaluated faculty development workshops for surgeons that used trigger videos as a tool to improve IOT. The participants were engaged and stimulated during their discussions amongst their peers in both the large and small group formats. Feedback from participants was overwhelmingly positive with respect to the use of trigger videos as a cornerstone of these sessions. A total of 500 unique IOT points were generated by participants who completed the post-workshop questionnaires, indicating that they were able to relate the workshop content to their own teaching experiences.
A barrier to faculty development in surgery is interest.5 The use of videos in medical education has been used to overcome this barrier, as they can encourage interactivity to improve learning.13 For simple content, how-to videos are excellent at showing or explaining concepts. For complex content where participants need to remain engaged and interactive, trigger videos are indispensable for generating discussion among peers. Our results show that the trigger videos used in our workshops are capable of inciting dialogue while keeping participants engaged. Positive feedback on the evaluation questionnaires showed that the surgeons enjoyed using the videos and their open-ended responses demonstrated that the videos generated reflection, discussion, and plans for behaviour change.
Our finding that trigger videos can be an excellent stimulus for discussion has been replicated in other studies. Ber and Alroy used trigger videos to teach aspects of professionalism to medical students, finding that participants identified a multitude of issues relative to the topic.14 In our study, surgeons were able to identify unique issues and challenges they faced in their own daily teaching practice. Despite viewing the same videos, each group highlighted a variety of discussion points related to IOT. This allowed for rich discussion in the small groups, which set the foundation for broader large group discourse. Ber and Alroy also found that medical students’ perspectives on professionalism differed when viewing trigger videos prior to clerkship compared to viewing the videos after initiating clinical experience, indicating that the same trigger video format can be used at different stages of training.14 Surgeons in our workshops had varying levels of teaching experience and were able to learn from the trigger videos and from their peers. In a study by Nichols, when used in nursing education, trigger videos were noted to be excellent discussion stimulators and were rated as highly enjoyable among the students.10 These findings parallel the results of our study and also suggest that trigger videos can be successful in multiple educational settings.
This paper describes a novel application of trigger videos in the setting of faculty development workshops where surgical faculty learn about IOT. Coaching, small group sessions, and video-based education have been highlighted as the top three learning modalities for faculty development.5 Our video-based workshops with small group discussion capitalized on two of these techniques. Using the trigger videos as an anchor, surgeons were able to identify and discuss the IOT challenges they face in their own daily practice and strategies to tackle them. Participants were also able to learn from their peers, as each small group focused on specific points introduced in the trigger videos. They shared by reporting the elements of their small group discussions to the larger group, benefiting the entire workshop. The facilitators presented literature that supported the IOT techniques to further solidify what the surgeons had learned during these interactive workshops.
The trigger video is a successful tool because it is immersive. It uses active learning techniques to improve retention of material, encourage motivation for further study, and develop new thinking skills.15 We believe that the trigger video works by forcing participants to debrief their immersive experiences, allowing for deep reflection and critical thinking among peers in a non-judgemental environment. Debriefing is cited as one of the most important aspects of learning because it translates an experience into an analyzed and interpreted event.16 In our faculty development workshops for surgeons, deep reflection and critical thinking during discussion with peers caused participants to evaluate their own IOT styles and behaviours and how they intend to change the way they teach. Based on surgeons’ feedback and identification of 500 unique IOT concepts, we believe trigger videos were a highly valuable component of our faculty development workshops.
Barriers to faculty development include financial support for implementing workshops.5 A trigger video is an inexpensive tool that can be used multiple times. Videos are ubiquitous, can be shot easily or found online (including those we developed for our workshops, available in Appendix 1). Additionally, video can easily be shown online and on virtual platforms, making trigger videos an attractive solution for engaging surgeons during faculty development initiatives on virtual platforms. For example, a trigger video can be shown to a large online group, followed by virtual breakout “rooms” for discussion, and then reconvening in a large group format virtually.
Our study’s strengths include the vast acceptance of the trigger videos by the surgeons in the workshops, the demonstration that trigger videos are an engaging tool that can generate discussion about complex concepts such as IOT, and the potential for generalizability from local to multi-institutional delivery of the workshops with a variety of surgeons. The study is limited in that our data may be skewed by participation bias, as surgeons who chose to attend these faculty development sessions may already have an interest in teaching. Furthermore, scheduling of faculty development workshops is a barrier for some, as is the case with many scheduled teaching initiatives. However, with the potential for the use of workshops with trigger videos on a virtual platform, this could alleviate scheduling conflicts for those who wish to participate.
Surgical faculty development initiatives should focus on training participants for their new teaching and assessment roles in the CBME era.5 To ensure their residents and fellows attain and demonstrate competency, surgeons need to focus on their own IOT skills. In our study, small-group sessions using trigger videos were effective at encouraging surgeons to focus on IOT skills. Our trigger videos are available free online (Appendix 1); but trigger videos can be created using ideas from existing videos, filmed to fit the needs of a workshop or other teaching initiative, and can be used on virtual platforms. Given our success with implementing trigger videos, we believe that strong consideration should be given to using this tool to anchor faculty development sessions focused on IOT. Furthermore, given that trigger videos can be tailored to multiple scenarios, they may be a useful component for other types of teaching modalities and transferable to other medical specialties.