Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Shared Learning Utilizing Digital Methods in Surgery to Enhance Transparency in Surgical Innovation: Protocol for a Scoping Review

Shared Learning Utilizing Digital Methods in Surgery to Enhance Transparency in Surgical... Background: Surgical innovation can lead to important improvements in patient outcomes. Currently, information and knowledge about novel procedures and devices are disseminated informally and in an unstandardized way (eg, through social media). This can lead to ineffective and inefficient knowledge sharing among surgeons, which can result in the harmful repetition of mistakes and delay in the uptake of promising innovation. Improvements are needed in the way that learning in surgical innovation is shared through the development of novel, real-time methods, informed by a contemporary and comprehensive investigation of existing methods. Objective: The aim of this scoping review is to explore the application of existing digital methods for training/education and feedback to surgeons in the context of performing invasive surgical procedures. This work will (1) summarize existing methods for shared learning in surgery and how they are characterized and operationalized, (2) examine the impact of their application, and (3) explore their benefits and barriers to implementation. The findings of this scoping review will inform the development of novel, real-time methods to optimize shared learning in surgical innovation. Methods: This study will adhere to the recommended guidelines for conducting scoping reviews. A total of 6 different searches will be conducted within multiple sources (2 electronic databases, journals, social media, gray literature, commercial websites, and snowball searches) to comprehensively identify relevant articles and data. Searches will be limited to articles published in the English language within the last 5 years. Wherever possible, a 2-stage study selection process will be followed whereby the eligibility of articles will be assessed through the title, abstract, and full-text screening independently by 2 reviewers. Inclusion criteria will be articles providing data on (1) fully qualified theater staff involved in performing invasive procedures, (2) one or more methods for shared learning (ie, digital means for training/education and feedback), and (3) qualitative or quantitative evaluations of this method. Data will be extracted (10% double data extraction by an independent reviewer) into a piloted proforma and analyzed using descriptive statistics, narrative summaries, and principles of thematic analysis. Results: The study commenced in October 2021 and is planned to be completed in 2023. To date, systematic searches were applied to 2 electronic databases (MEDLINE and Web of Science) and returned a total of 10,093 records. The results of this scoping review will be published as open access in a peer-reviewed journal. https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 1 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al Conclusions: This scoping review of methods for shared learning in surgery is, to our knowledge, the most comprehensive and up-to-date investigation that maps current information on this topic. Ultimately, efficient and effective sharing of information and knowledge of novel procedures and devices has the potential to optimize the evaluation of early-phase surgical research and reduce harmful innovation. International Registered Report Identifier (IRRID): PRR1-10.2196/37544 (JMIR Res Protoc 2022;11(9):e37544) doi: 10.2196/37544 KEYWORDS innovation; surgery; surgical; shared learning; scoping review; operative; procedures; digital; training; learning; feedback; digital method; review; review methodology; surgeon; education; medical education; eHealth; digital health; digital tool case-by-case learning when developing a new surgical Introduction technique. Such methods must also include mechanisms for the confidential provision of feedback to avoid patient harm while Background simultaneously ensuring a safe space for surgical innovation. Surgical innovation is common and plays a crucial role in A number of digital methods to provide feedback exist, advancing surgical practice. It is characterized by a including image analysis [16], artificial intelligence [17], or developmental process whereby novel procedures and devices virtual and telementoring platforms [18]. These have been evolve from early ideas and first-in-human studies to demonstrated to improve outcomes relevant to patients (eg, longer-term evaluations. Surgeons acquire important learning reduced operative time) and surgeons (eg, improved surgical from incremental cases [1-3], leading to a steep learning curve skills) for established procedures [19,20]. It is therefore possible in the early phases of technique development. Transparent that similar methods could be used or adapted to capture the sharing of case-by-case learning is therefore critical to promote incremental learning associated with an innovative surgical efficient and safe innovation and timely evaluation of surgical technique in near real time. Digital methods may also enable innovation when a new technique has stabilized [2,4]. prompt sharing to facilitate efficient, transparent, and safe Currently, surgeons tend to innovate independently. Early innovation of novel surgical procedures. incremental learning, including modifications to the technique There is no standard definition of surgical innovation, and and its outcomes, is rarely shared beyond the local team, if at descriptions of novelty vary considerably across the literature all. Traditionally, dissemination of information about innovative [21,22]. Identification of relevant literature on surgical procedures occurs at a relatively late stage through surgeon innovation is also hindered by poor reporting [4,23,24]. innovators presenting their technique at meetings and Innovations are “frequently reported as information conferences, followed by taught courses and peer-reviewed communications which may not be well organized and are publications [1,5]. Key incremental case-by-case learning is sometimes anecdotal“ (pg 1) [25]. Standard systematic review often not recorded. Evidence in other areas has shown that the methodology would therefore be unlikely to identify relevant outcomes of using an innovation are positively affected when studies consistently and reliably. A literature synthesis that knowledge is shared between external stakeholders [6], which adopts a broad approach to include a wide variety of publication can even be a source of innovation itself [7]. Increased shared types is required to capture a range of digital methods for shared learning in surgical innovation may provide similar benefits. learning in surgery in general. Initial scoping searches (using Disseminating new knowledge in health care is known to be Google) showed no such review has been conducted. A scoping challenging [8]. The process of exchanging information can be review is considered a suitable approach for mapping a complex influenced by a multiplicity of factors, including organizational, topic area where no prior investigation exists [26-28]. Methods cultural, social, and psychological influences [9,10] and allow inclusion of a range of study designs without requiring a facilitated by technology [11]. More recently, surgeon innovators formal quality assessment of the included articles. A scoping are increasingly utilizing digital platforms and social media to review of currently available methods used to share learning in disseminate ideas and practice [12]. While this has notable surgery can identify potentially relevant digital methods, which benefits, the acquired knowledge is shared inconsistently in turn can inform the development of novel methods to optimize [13,14]. It may promote optimism bias by preferentially favoring shared learning in surgical innovation. positive developments and outcomes and is unsuited to building Aims and Objectives a robust evidence base [15]. Furthermore, approaches to disseminating information provide little or no scope for The aim of this scoping review is to explore the application of feedback, hindering efficient innovation that can address digital methods for training/education and feedback for shared learning curve effects. This may also mean the benefits and learning in the context of invasive surgical procedures. We harm outcomes of innovation are underreported or not shared aimed to: transparently, and opportunities to promote patient safety by Summarize existing methods for shared learning (ie, digital avoiding repetition of potentially harmful mistakes are therefore methods for learning or education and feedback) and how lost. Methods for effectively and transparently sharing they are characterized and operationalized information in real time are needed to accommodate incremental, https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 2 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al Examine the impact of the applications of methods for education and feedback in surgery can include but are not shared learning from data on the evaluation of methods limited to assessment of skills; performance or outcomes; Explore benefits and barriers to the implementation of proctorship, mentoring, apprenticeships; and demonstration of methods for shared learning from data on the evaluation of techniques and simulation. methods Digital Methods Results will inform strategies for embedding suitable methods Digital methods will be defined as utilizing electronic within an electronic platform for real-time reporting and sharing technology that is able to generate, store, and process data. In of outcomes of surgical innovation. this review, we will exclude any methods that are used in situ (eg, laparoscopic equipment that includes cameras to broadcast Methods to screens located in the operating theater). Overview Invasive Procedure A scoping review was chosen to investigate this topic due to An invasive procedure is defined as “one where the breadth and type of the data of interest for the research purposeful/deliberate access to the body is gained via an question. This scoping review will be conducted adhering to incision, percutaneous puncture, where instrumentation is used the PRISMA (Preferred Reporting Items for Systematic Reviews in addition to the puncture needle, or instrumentation via a and Meta-Analyses) extension for scoping reviews natural orifice. It begins when entry to the body is gained and (PRISMA-ScR) and established frameworks for conducting ends when the instrument is removed, and/or the skin is closed. scoping reviews [26,28-30]. An initially completed checklist Invasive procedures are performed by trained healthcare can be found in Multimedia Appendix 1 [28], and an updated professionals using instruments, which include, but are not checklist will be provided upon publication of results. Two limited to, endoscopes, catheters, scalpels, scissors, devices and trained reviewers will conduct the review, with input from a tubes” (pg 2) [32]. multidisciplinary team consisting of surgeons, methodologists, Surgical Innovation health services researchers, and social scientists. Any necessary There is no agreed definition of innovative surgical innovation deviations from the current protocol will be reported in the [21,22,33] and no validated methods to identify the phase of completed manuscript. evaluation retrospectively in the published literature. Innovative Ethical Considerations surgical procedures were therefore defined as those where Ethical approval for this scoping review was not required, authors self-report an invasive procedure as “new” or because it does not involve human participants, their tissue, “modified,” corresponding to phases 1, 2a, and 2b of the IDEAL data or samples or has ethical implications, as outlined in (Idea, Development, Exploration, Assessment, Long-term study) institutional policies including Section 2 of the University of framework [34,35]. Bristol's Ethics of Research Policy and Procedure. Identifying Relevant Articles Definitions Data Sources Shared Learning Scoping searches conducted to inform our study have confirmed There is no consensus definition of shared learning in the health that relevant information is contained in a variety of data sources care or surgical literature [31]. For the purposes of this review, beyond traditional peer-reviewed publications. A number of we have defined shared learning as a method of providing different data sources are proposed to be of value for navigating training/education with feedback to 2 or more clinicians the unique landscape of available evidence and addressing the undertaking surgical procedures. Examples of training or study aim (Table 1). Table 1. Publication types considered in this review, with examples of possible data sources. Publication type Possible data sources (examples) Peer-reviewed publications Protocols, conference abstracts, empirical studies of any publication type (eg, pilot, feasibility, methodological, diag- nostic accuracy, intervention, and observational studies) Opinion pieces Editorials, comments, letters, perspectives, news, bulletins Social media Twitter posts, YouTube videos Gray literature Scientific, academic, government, or commercial reports (eg, reports of artificial intelligence or virtual reality systems) Commercial online resources Websites of manufacturers and platform/software/hardware providers related to training/education and feedback systems (eg, Johnson & Johnson, Medtronic, Proximie, Explorer Surgical, Visual Lab 360, Kognito, Oxford Medical Simulation, and Immersive Touch) librarian will aid optimization of searches and inclusivity of Searches search terms throughout. A total of 6 approaches will be followed to identify relevant data sources detailed above. Collaboration with a subject https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 3 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al and combined with Boolean search operators to retrieve relevant Electronic Database Searches content. A comprehensive search strategy for conducting electronic database searches will be developed. Keywords will be based Gray Literature on the study eligibility criteria using the search strings “shared A search of the gray literature will be conducted to identify learning” AND “methods” AND “invasive procedures.” potentially relevant articles not indexed in electronic databases. Targeted internet searches and relevant existing search strategies Specific sources to search for gray literature include OpenGrey, (eg, for invasive procedures [32]) will be used to inform the list Canada’s Drug and Health Technology Agency's Gray Matters, of keywords. Search strategies can be found in Multimedia Healthcare Management Information Consortium, National Appendix 2. Technical Information Service, and American Psychological The search strategy will be translated to search for relevant Association PsycExtra, and internet searches (eg, using Google). publications in MEDLINE (Ovid version) and Web of Science. Simple search terms will be used for these searches and adjusted based on gray literature sources and results. Any adjustments, Journal Searches if necessary, will be reported in the final manuscript. Scientific journals that are likely to publish relevant papers will Handsearching of Commercial Websites be searched manually to identify any peer-reviewed articles that may be missed through electronic database searches. Contents Websites of commercial providers of digital platforms or pages of journals will be reviewed with a date of publication software that are known to the research team will be searched within the last 5 years. Journals of interest will be identified to identify further relevant information on digital methods for through expert knowledge and journal databases (eg, Web of shared learning. Relevant websites of known surgical Science Master Journal List). Relevant journals identified a technologies and technology providers will include but are not priori include Journal of Medical Internet Research, BMJ limited to Proximie, Explorer Surgical, Visual Lab 360, Kognito, Surgery, Interventions & Health Technologies, Surgical Oxford Medical Simulation, Touch Surgery, Immersive Touch, Innovation, Health Information Research, Methods of Johnson & Johnson, and Medtronic. Commercial providers that Information in Medicine, and Applied Clinical Informatics. do not have product-ready solutions or are currently still in Additional journals from previously identified articles will be development and/or lack relevant publicly available data will added as appropriate. be excluded. Social Media Snowball Searches Social media platforms Twitter and YouTube have been One-layer forward snowball searches (citation mining) and identified as common sources for sharing knowledge about reverse snowballing (chain searching) will be applied to all surgical innovation [36] and will therefore serve as an additional included papers to capture related publications that may fall data source to inform the extent of their utility. Multiple different outside of the established search strategy. Any relevant review methods for querying social media platforms exist with known article (including systematic, scoping, literature, and narrative advantages and limitations [37]. Information will be searched reviews) identified through any of the above searches will be by entering keywords related to “surgery” (eg, surgical, retrieved and their reference lists screened for further potentially procedure) and “innovation” (eg, novel, improved, recently eligible records. developed, adapted) into the social media platforms’ own Study Eligibility advanced search functions (eg, Twitter application programming Study eligibility criteria are defined according to the Population, interface). These functions are free to use, providing access to Concept, and Context framework [38] and are presented in Table 1% of real-time content. Automated dashboard vendors provide 2. Publications will only be considered if they are dated within licensed software for the retrieval and analysis of social media 5 years of their original publication date to ensure data is content (eg, Mediatoolkit, Radian6). Dashboard vendors provide contemporary. Articles will also be excluded if they are not access to the full content of posts across a range of social media published in the English language, due to resource restrictions platforms. They will be considered to supplement searches if that prevent the translation of non-English articles. social media posts identified through advanced search functions are considered insufficient. The same keywords will be used https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 4 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al Table 2. Study eligibility criteria. Element Inclusion criteria Exclusion criteria Population Adult (>18 years) human population Individuals not qualified to undertake an invasive procedure • • Any individual qualified to undertake an invasive procedure (eg, medical students, undergraduates) (eg, junior doctors, surgeons, physicians, consultants, radiol- ogists, endoscopists, gastroenterologists, cardiologists, ad- vanced nurse practitioners) Concept Discuss, report, and/or evaluate one or more methods for Focus on digital method(s) for shared learning that are solely • • shared learning (ie, for training/education and feedback) aimed to be used in situ (eg, laparoscopic techniques that have Must utilize digital means for shared learning a camera installed and broadcast inside the operating theater) Quantitatively or qualitatively evaluate the method for shared Simple descriptive presentation of the method for shared • • learning learning Context Must be in the context of invasive procedures • • N/A N/A: not applicable. further information on their content (eg, presence of a link to Study Selection an external website). An initial data extraction form will be For records with common publication formats (ie, published a piloted with a small number of relevant articles (see Multimedia title, structured abstract, executive summary, or synopsis), a Appendix 3). The form will be iteratively refined to 2-stage screening process will be undertaken to assess records comprehensively capture all relevant detail emerging during for inclusion against the study eligibility criteria. the pilot. Search results will be downloaded from their respective online One review author will extract data from all included studies, databases, deduplicated, and uploaded to an online review and a second reviewer will independently perform double data manager (Rayyan) [39]. In a first step, 3 review authors (CH, extraction for at least 10% of articles. Consistency in the MK, and JR) will independently (each review author will be approach to data extraction will be ensured through constant blind to the screening choice of the others) screen the titles and dialogue between the 2 reviewers. abstracts, executive summaries, or synopses of the retrieved Data Analysis records, with 10% of records double-screened. Full texts of articles will be obtained from records meeting the inclusion Findings will be summarized in tables using descriptive statistics criteria and from those where inclusion remains uncertain (eg, and in narrative form. Verbatim extracted data will be analyzed because of a lack of information from the abstract). In a second by 2 reviewers adhering to principles of thematic analysis [40]. step, 2 reviewers will each screen half of the retrieved full texts Identified themes will be displayed in schematics. Any verbatim independently to assess full eligibility. Duplicate assessment extracted data will be reviewed to identify barriers and benefits of eligibility will be performed on 10% of all full texts with to the implementation of shared learning methods. Barriers will further duplicate reviews in case of poor agreement (<80%). be considered factors that impede the implementation of methods for shared learning in clinical practice. Benefits will It is anticipated that some potentially relevant records do not be considered those that enable implementation [41]. Two follow conventional publication formats (eg, tweets, opinion reviewers will code data as a barrier or benefit, whereby regular pieces, news articles). In this case, 2 reviewers will meetings will be held to discuss coding results, and senior independently review the content of the record in full. authors will be involved where consensus is required. In case Discrepancies at any stage of the screening process will initially an automated dashboard vendor is used to identify social media be discussed between the 2 review authors. A third independent posts, the content will undergo additional analysis using the reviewer (SP) will arbitrate where agreement on inclusion could software’s existing classification algorithms and analyses (eg, not be reached, and input from the wider team will be sought sentiment analysis). where necessary. Results Data Extraction This work was initiated in October 2021. Iterative refinements Data extraction will be performed directly into a purposely to the scoping review protocol and formalizing of methods were designed electronic data extraction form (eg, Microsoft Access; completed in January 2021. Targeted searches were conducted Microsoft Corp). Details about (1) study and publication in December 2021 to inform the development of a characteristics (eg, author, study design, funding, and comprehensive search strategy for electronic database searches. sponsorship statements), (2) the method for shared learning (eg, This strategy was iteratively developed for and tested in purpose, type, operationalization, and modality), and (3) impact MEDLINE. The final search was applied to MEDLINE and of methods for shared learning (eg, methodology of evaluating Web of Science in March 2022 and yielded a total of 10,093 methods for shared learning and their results, limitations, and records. Identification of relevant articles is currently ongoing author recommendations) will be extracted. Additional items and is expected to be completed by December 2022. Study of interest for social media posts will be explored to capture https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 5 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al selection, data extraction and analysis, and drafting of the efficiency and effectiveness of disseminating knowledge and manuscript to report the results of this scoping review will be information about novel procedures and devices. Essential to conducted throughout 2023. Open access peer-reviewed this ongoing work is the codevelopment of a real-time electronic publication is expected in 2023. Any changes to the methods platform that aims to collect, analyze, and feedback data about reported here will be documented and reported. novel procedures and devices. Such an electronic platform will host a range of evidence-based approaches to safe and Discussion transparent surgical innovation that can facilitate the standardized collection and sharing of information and This scoping review will explore methods for the application knowledge about novel procedures and devices [2,4]. Ultimately, of digital methods for training/education and feedback for shared enhancing shared learning in this way will reduce the risk of learning in the context of invasive surgical procedures. This avoidable patient harm and streamline the evaluation of work is, to the authors’ knowledge, the first to (1) summarize early-phase invasive procedures and devices. the application of existing methods for shared learning, (2) This work will adhere to a robust methodology following the examine the impact of their application, and (3) explore the recommended standards for conducting scoping reviews benefits and barriers to their implementation in the context of [26,28,29]. This will ensure transparency and reduced risk of surgery. This scoping review protocol outlines a total of 6 bias. Common limitations of scoping reviews, which also apply different approaches to identify relevant articles and data to to our work, should be noted. Searches will be restricted to the comprehensively map currently available information on this English language, which limits our ability to summarize and topic. examine findings from methods for shared learning in The results will provide an investigation of contemporary non–English-speaking contexts. Identifying surgical innovation methods, which will be of interest to health care professionals and related information is hindered by poor reporting and and methodologists wishing to adopt methods for shared informal dissemination. This work will intentionally address learning in surgical practice. Crucially, this work will contribute this challenge through an extensive search, but this may still to ongoing research that aims to optimize safe and transparent not be sufficient to exhaustively capture all existing work using innovation by promoting the sharing of incremental case-by-case literature synthesis methods. Electronic database searches will learning among surgeons performing new procedures. be limited to 2 databases. Expert advice was sought, and it is Knowledge sharing in surgical innovation has not yet received expected that most of the relevant information on shared learning much research attention, and there may be additional challenges is included in these databases. However, there is a possibility that need to be considered. For example, surgeon innovators that additional information of interest may be missed. may be reluctant to share ideas and might show hesitancy in In conclusion, this scoping review will enhance our knowledge light of potential impacts on confidentiality or reputation. There about the application of contemporary digital methods for is currently no evidence that demonstrates the underlying training/education and feedback for shared learning in the mechanisms that may impact surgeon innovators’ behavior context of invasive surgical procedures. This work is vital to toward sharing learning. This is an important avenue for future help inform the development of novel methods to optimize research requiring further exploration in qualitative work. shared learning in surgical innovation through the integration The findings from this scoping review will provide an initial of findings into an electronic platform for real-time reporting step to inform the development of strategies to improve the and sharing of outcomes related to surgical innovation. Acknowledgments This study was supported by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC) at University Hospitals Bristol and Weston National Health Service Foundation Trust and the University of Bristol (BRC-1215-20011). This work was supported by the Royal College of Surgeons of England Bristol Surgical Trials Centre. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR, the Royal College of Surgeons of England, or the Department of Health and Social Care. SP is an NIHR clinician scientist (NIHR CS-2016-16-019). NB is a Medical Research Council clinician scientist. JMB is an NIHR senior investigator. Data Availability This review will not generate any new data. All extracted data and results of the analyses will be made available as supplementary material in the publication of the review results. Authors' Contributions JMB, SP, KNLA, and NB developed the idea for this study. CH and MK prepared the protocol, which was reviewed, discussed, and approved by the entire study team. CH, MK, NA, and JR established and formulated the methods for this review, with input from RM, SP, KNLA, and SP. SP will provide general oversight for this study. SP, NB, and JMB will take the lead in implementing the findings from this study. https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 6 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al Conflicts of Interest JMB is a member of the Core Outcome Measures for Effectiveness Trials Initiative Management Group. All other authors declare no conflicts of interest. Multimedia Appendix 1 PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews) checklist. [PDF File (Adobe PDF File), 131 KB-Multimedia Appendix 1] Multimedia Appendix 2 Search strategy for database searches. [PDF File (Adobe PDF File), 145 KB-Multimedia Appendix 2] Multimedia Appendix 3 Initial list of data items to extract from eligible articles. [PDF File (Adobe PDF File), 127 KB-Multimedia Appendix 3] References 1. Barkun JS, Aronson JK, Feldman LS, Maddern GJ, Strasberg SM. Evaluation and stages of surgical innovations. The Lancet 2009 Sep 26;374(9695):1089-1096. [doi: 10.1016/S0140-6736(09)61083-7] [Medline: 19782874] 2. Hoffmann C, Hossaini S, Cousins S, Blencowe N, McNair AGK, Blazeby JM, et al. Reporting modifications in surgical innovation: a systematic scoping review protocol. Int J Surg Protoc 2021;25(1):250-256 [FREE Full text] [doi: 10.29337/ijsp.167] [Medline: 34825118] 3. Garas G, Cingolani I, Panzarasa P, Darzi A, Athanasiou T. Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery. PLoS One 2017 Aug 25;12(8):e0183332 [FREE Full text] [doi: 10.1371/journal.pone.0183332] [Medline: 28841648] 4. Avery K, Wilson N, Macefield R, McNair A, Hoffmann C, Blazeby J, et al. A Core Outcome Set for Seamless, Standardized Evaluation of Innovative Surgical Procedures and Devices (COHESIVE): a patient and professional stakeholder consensus study. Ann Surg 2021 Jun 07:2021. [doi: 10.1097/SLA.0000000000004975] [Medline: 34102667] 5. Dengler J, Padovano WM, Davidge K, McKay V, Yee A, Mackinnon SE. Dissemination and implementation science in plastic and reconstructive surgery: perfecting, protecting, and promoting the innovation that defines our specialty. Plast Reconstr Surg 2021 Feb 01;147(2):303e-313e. [doi: 10.1097/PRS.0000000000007492] [Medline: 33009331] 6. Ritala P, Olander H, Michailova S, Husted K. Knowledge sharing, knowledge leaking and relative innovation performance: An empirical study. Technovation 2015 Jan;35:22-31. [doi: 10.1016/j.technovation.2014.07.011] 7. Dhanaraj C, Parkhe A. Orchestrating innovation networks. AMR 2006 Jul;31(3):659-669. [doi: 10.5465/amr.2006.21318923] 8. Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. BMJ 1998 Aug 15;317(7156):465-468 [FREE Full text] [doi: 10.1136/bmj.317.7156.465] [Medline: 9703533] 9. Sanson-Fisher RW. Diffusion of innovation theory for clinical change. Med J Aust 2004 Mar 15;180(S6):S55-S56. [doi: 10.5694/j.1326-5377.2004.tb05947.x] [Medline: 15012582] 10. Rogers E, Singhal A, Quinlan M. Diffusion of innovations. In: Stacks DW, Salwen MB, Eichhorn KC, editors. An Integrated Approach to Communication Theory and Research, 2nd ed. New York, NY: Routledge; 2008:432-448. 11. Pandey J, Gupta M, Behl A, Pereira V, Budhwar P, Varma A, et al. Technology-enabled knowledge management for community healthcare workers: The effects of knowledge sharing and knowledge hiding. J Bus Res 2021 Oct;135:787-799. [doi: 10.1016/j.jbusres.2021.07.001] 12. Ahmed YA, Ahmad MN, Ahmad N, Zakaria NH. Social media for knowledge-sharing: A systematic literature review. Telemat 2019 Apr;37:72-112. [doi: 10.1016/j.tele.2018.01.015] 13. Dimick JB, Sedrakyan A, McCulloch P. The IDEAL framework for evaluating surgical innovation: how it can be used to improve the quality of evidence. JAMA Surg 2019 Aug 01;154(8):685-686. [doi: 10.1001/jamasurg.2019.0903] [Medline: 31166583] 14. Arroyo NA, Gessert T, Hitchcock M, Tao M, Smith CD, Greenberg C, et al. What promotes surgeon practice change? A scoping review of innovation adoption in surgical practice. Ann Surg 2021 Mar 01;273(3):474-482. [doi: 10.1097/SLA.0000000000004355] [Medline: 33055590] 15. Wang Y, McKee M, Torbica A, Stuckler D. Systematic literature review on the spread of health-related misinformation on social media. Soc Sci Med 2019 Nov;240:112552 [FREE Full text] [doi: 10.1016/j.socscimed.2019.112552] [Medline: 31561111] https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 7 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al 16. Sánchez-González P, Cano AM, Oropesa I, Sánchez-Margallo FM, Del Pozo F, Lamata P, et al. Laparoscopic video analysis for training and image-guided surgery. Minim Invasive Ther Allied Technol 2011 Dec;20(6):311-320. [doi: 10.3109/13645706.2010.541921] [Medline: 21247251] 17. Lui TK, Wong KK, Mak LL, To EW, Tsui VW, Deng Z, et al. Feedback from artificial intelligence improved the learning of junior endoscopists on histology prediction of gastric lesions. Endosc Int Open 2020 Feb 22;8(2):E139-E146 [FREE Full text] [doi: 10.1055/a-1036-6114] [Medline: 32010746] 18. Artsen AM, S Burkett L, Duvvuri U, Bonidie M. Surgeon satisfaction and outcomes of tele-proctoring for robotic gynecologic surgery. J Robot Surg 2022 Jun 16;16(3):563-568 [FREE Full text] [doi: 10.1007/s11701-021-01280-x] [Medline: 34272656] 19. Gurusamy K, Aggarwal R, Palanivelu L, Davidson BR. Systematic review of randomized controlled trials on the effectiveness of virtual reality training for laparoscopic surgery. Br J Surg 2008 Sep;95(9):1088-1097. [doi: 10.1002/bjs.6344] [Medline: 18690637] 20. Larsen CR, Oestergaard J, Ottesen BS, Soerensen JL. The efficacy of virtual reality simulation training in laparoscopy: a systematic review of randomized trials. Acta Obstet Gynecol Scand 2012 Sep;91(9):1015-1028 [FREE Full text] [doi: 10.1111/j.1600-0412.2012.01482.x] [Medline: 22693954] 21. Birchley G, Ives J, Huxtable R, Blazeby J. Conceptualising surgical innovation: an eliminativist proposal. Health Care Anal 2020 Mar;28(1):73-97 [FREE Full text] [doi: 10.1007/s10728-019-00380-y] [Medline: 31327091] 22. Hutchison K, Rogers W, Eyers A, Lotz M. Getting clearer about surgical innovation: a new definition and a new tool to support responsible practice. Ann Surg 2015 Dec;262(6):949-954. [doi: 10.1097/SLA.0000000000001174] [Medline: 25719812] 23. Macefield R, Wilson N, Hoffmann C, Blazeby J, McNair A, Avery K, et al. Outcome selection, measurement and reporting for new surgical procedures and devices: a systematic review of IDEAL/IDEAL-D studies to inform development of a core outcome set. BJS Open 2020 Oct 04;4(6):1083 [FREE Full text] [doi: 10.1002/bjs5.50358] [Medline: 33016009] 24. Hoffmann C, Macefield RC, Wilson N, Blazeby JM, Avery KNL, Potter S, et al. A systematic review and in-depth analysis of outcome reporting in early phase studies of colorectal cancer surgical innovation. Colorectal Dis 2020 Dec 23;22(12):1862-1873. [doi: 10.1111/codi.15347] [Medline: 32882087] 25. Sharma D, Harris M, Agrawal V, Agarwal P. Plea for standardised reporting of frugal innovations. BMJ Innov 2021 Sep 13;7(4):642-646. [doi: 10.1136/bmjinnov-2021-000710] 26. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005 Feb;8(1):19-32. [doi: 10.1080/1364557032000119616] 27. Rumrill PD, Fitzgerald SM, Merchant WR. Using scoping literature reviews as a means of understanding and interpreting existing literature. Work 2010;35(3):399-404. [doi: 10.3233/WOR-2010-0998] [Medline: 20364059] 28. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, Tunçalp, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018 Oct 02;169(7):467-473. [doi: 10.7326/M18-0850] [Medline: 30178033] 29. Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci 2010;5:69 [FREE Full text] [doi: 10.1186/1748-5908-5-69] [Medline: 20854677] 30. Tricco AC, Lillie E, Zarin W, O'Brien K, Colquhoun H, Kastner M, et al. A scoping review on the conduct and reporting of scoping reviews. BMC Med Res Methodol 2016 Feb 09;16:15 [FREE Full text] [doi: 10.1186/s12874-016-0116-4] [Medline: 26857112] 31. Cannavina G, Wood D, Winstanley RB, Walsh TF. A retrospective study of shared learning on the BMedSci Dental Technology course at The University of Sheffield. Eur J Dent Educ 2000 Nov;4(4):160-164. [doi: 10.1034/j.1600-0579.2000.040403.x] [Medline: 11168481] 32. Cousins S, Blencowe NS, Blazeby JM. What is an invasive procedure? A definition to inform study design, evidence synthesis and research tracking. BMJ Open 2019 Jul 30;9(7):e028576 [FREE Full text] [doi: 10.1136/bmjopen-2018-028576] [Medline: 31366651] 33. Rogers W, Lotz M, Hutchison K, Pourmoslemi A, Eyers A. Identifying surgical innovation: a qualitative study of surgeons' views. Ann Surg 2014 Feb;259(2):273-278. [doi: 10.1097/SLA.0b013e31829ccc5f] [Medline: 23787218] 34. McCulloch P, Cook JA, Altman DG, Heneghan C, Diener MK, IDEAL Group. IDEAL framework for surgical innovation 1: the idea and development stages. BMJ 2013 Jun 18;346:f3012 [FREE Full text] [doi: 10.1136/bmj.f3012] [Medline: 23778427] 35. Ergina PL, Barkun JS, McCulloch P, Cook JA, Altman DG, IDEAL Group. IDEAL framework for surgical innovation 2: observational studies in the exploration and assessment stages. BMJ 2013 Jun 18;346:f3011 [FREE Full text] [doi: 10.1136/bmj.f3011] [Medline: 23778426] 36. Bennett KG, Berlin NL, MacEachern MP, Buchman SR, Preminger BA, Vercler CJ. The ethical and professional use of social media in surgery: a systematic review of the literature. Plast Reconstr Surg 2018 Sep;142(3):388e-398e [FREE Full text] [doi: 10.1097/PRS.0000000000004692] [Medline: 30148789] 37. Kim AE, Hansen HM, Murphy J, Richards AK, Duke J, Allen JA. Methodological considerations in analyzing Twitter data. J Natl Cancer Inst Monogr 2013 Dec;2013(47):140-146. [doi: 10.1093/jncimonographs/lgt026] [Medline: 24395983] https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 8 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al 38. Peters MDJ, Godfrey C, McInerney P, Munn Z, Trico AC, Khalil H. Chapter 11: Scoping reviews. JBI Manual for Evidence Synthesis. 2020. URL: https://doi.org/10.46658/JBIMES-20-01 [accessed 2022-08-11] 39. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016 Dec 05;5(1):210 [FREE Full text] [doi: 10.1186/s13643-016-0384-4] [Medline: 27919275] 40. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006 Jan;3(2):77-101. [doi: 10.1191/1478088706qp063oa] 41. Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci 2015;10:53 [FREE Full text] [doi: 10.1186/s13012-015-0242-0] [Medline: 25895742] Abbreviations BRC: Biomedical Research Centre IDEAL: Idea, Development, Exploration, Assessment, Long-term study NIHR: National Institute for Health and Care Research PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA-ScR: PRISMA extension for scoping reviews Edited by T Leung; submitted 24.02.22; peer-reviewed by L Irgang, K Matthias, K Mears; comments to author 04.08.22; revised version received 11.08.22; accepted 16.08.22; published 08.09.22 Please cite as: Hoffmann C, Kobetic M, Alford N, Blencowe N, Ramirez J, Macefield R, Blazeby JM, Avery KNL, Potter S Shared Learning Utilizing Digital Methods in Surgery to Enhance Transparency in Surgical Innovation: Protocol for a Scoping Review JMIR Res Protoc 2022;11(9):e37544 URL: https://www.researchprotocols.org/2022/9/e37544 doi: 10.2196/37544 PMID: ©Christin Hoffmann, Matthew Kobetic, Natasha Alford, Natalie Blencowe, Jozel Ramirez, Rhiannon Macefield, Jane M Blazeby, Kerry N L Avery, Shelley Potter. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 08.09.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included. https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 9 (page number not for citation purposes) XSL FO RenderX http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JMIR Research Protocols JMIR Publications

Shared Learning Utilizing Digital Methods in Surgery to Enhance Transparency in Surgical Innovation: Protocol for a Scoping Review

Loading next page...
 
/lp/jmir-publications/shared-learning-utilizing-digital-methods-in-surgery-to-enhance-WwlbwhZS1J

References (42)

Publisher
JMIR Publications
Copyright
Copyright © The Author(s). Licensed under Creative Commons Attribution cc-by 4.0
ISSN
1929-0748
DOI
10.2196/37544
Publisher site
See Article on Publisher Site

Abstract

Background: Surgical innovation can lead to important improvements in patient outcomes. Currently, information and knowledge about novel procedures and devices are disseminated informally and in an unstandardized way (eg, through social media). This can lead to ineffective and inefficient knowledge sharing among surgeons, which can result in the harmful repetition of mistakes and delay in the uptake of promising innovation. Improvements are needed in the way that learning in surgical innovation is shared through the development of novel, real-time methods, informed by a contemporary and comprehensive investigation of existing methods. Objective: The aim of this scoping review is to explore the application of existing digital methods for training/education and feedback to surgeons in the context of performing invasive surgical procedures. This work will (1) summarize existing methods for shared learning in surgery and how they are characterized and operationalized, (2) examine the impact of their application, and (3) explore their benefits and barriers to implementation. The findings of this scoping review will inform the development of novel, real-time methods to optimize shared learning in surgical innovation. Methods: This study will adhere to the recommended guidelines for conducting scoping reviews. A total of 6 different searches will be conducted within multiple sources (2 electronic databases, journals, social media, gray literature, commercial websites, and snowball searches) to comprehensively identify relevant articles and data. Searches will be limited to articles published in the English language within the last 5 years. Wherever possible, a 2-stage study selection process will be followed whereby the eligibility of articles will be assessed through the title, abstract, and full-text screening independently by 2 reviewers. Inclusion criteria will be articles providing data on (1) fully qualified theater staff involved in performing invasive procedures, (2) one or more methods for shared learning (ie, digital means for training/education and feedback), and (3) qualitative or quantitative evaluations of this method. Data will be extracted (10% double data extraction by an independent reviewer) into a piloted proforma and analyzed using descriptive statistics, narrative summaries, and principles of thematic analysis. Results: The study commenced in October 2021 and is planned to be completed in 2023. To date, systematic searches were applied to 2 electronic databases (MEDLINE and Web of Science) and returned a total of 10,093 records. The results of this scoping review will be published as open access in a peer-reviewed journal. https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 1 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al Conclusions: This scoping review of methods for shared learning in surgery is, to our knowledge, the most comprehensive and up-to-date investigation that maps current information on this topic. Ultimately, efficient and effective sharing of information and knowledge of novel procedures and devices has the potential to optimize the evaluation of early-phase surgical research and reduce harmful innovation. International Registered Report Identifier (IRRID): PRR1-10.2196/37544 (JMIR Res Protoc 2022;11(9):e37544) doi: 10.2196/37544 KEYWORDS innovation; surgery; surgical; shared learning; scoping review; operative; procedures; digital; training; learning; feedback; digital method; review; review methodology; surgeon; education; medical education; eHealth; digital health; digital tool case-by-case learning when developing a new surgical Introduction technique. Such methods must also include mechanisms for the confidential provision of feedback to avoid patient harm while Background simultaneously ensuring a safe space for surgical innovation. Surgical innovation is common and plays a crucial role in A number of digital methods to provide feedback exist, advancing surgical practice. It is characterized by a including image analysis [16], artificial intelligence [17], or developmental process whereby novel procedures and devices virtual and telementoring platforms [18]. These have been evolve from early ideas and first-in-human studies to demonstrated to improve outcomes relevant to patients (eg, longer-term evaluations. Surgeons acquire important learning reduced operative time) and surgeons (eg, improved surgical from incremental cases [1-3], leading to a steep learning curve skills) for established procedures [19,20]. It is therefore possible in the early phases of technique development. Transparent that similar methods could be used or adapted to capture the sharing of case-by-case learning is therefore critical to promote incremental learning associated with an innovative surgical efficient and safe innovation and timely evaluation of surgical technique in near real time. Digital methods may also enable innovation when a new technique has stabilized [2,4]. prompt sharing to facilitate efficient, transparent, and safe Currently, surgeons tend to innovate independently. Early innovation of novel surgical procedures. incremental learning, including modifications to the technique There is no standard definition of surgical innovation, and and its outcomes, is rarely shared beyond the local team, if at descriptions of novelty vary considerably across the literature all. Traditionally, dissemination of information about innovative [21,22]. Identification of relevant literature on surgical procedures occurs at a relatively late stage through surgeon innovation is also hindered by poor reporting [4,23,24]. innovators presenting their technique at meetings and Innovations are “frequently reported as information conferences, followed by taught courses and peer-reviewed communications which may not be well organized and are publications [1,5]. Key incremental case-by-case learning is sometimes anecdotal“ (pg 1) [25]. Standard systematic review often not recorded. Evidence in other areas has shown that the methodology would therefore be unlikely to identify relevant outcomes of using an innovation are positively affected when studies consistently and reliably. A literature synthesis that knowledge is shared between external stakeholders [6], which adopts a broad approach to include a wide variety of publication can even be a source of innovation itself [7]. Increased shared types is required to capture a range of digital methods for shared learning in surgical innovation may provide similar benefits. learning in surgery in general. Initial scoping searches (using Disseminating new knowledge in health care is known to be Google) showed no such review has been conducted. A scoping challenging [8]. The process of exchanging information can be review is considered a suitable approach for mapping a complex influenced by a multiplicity of factors, including organizational, topic area where no prior investigation exists [26-28]. Methods cultural, social, and psychological influences [9,10] and allow inclusion of a range of study designs without requiring a facilitated by technology [11]. More recently, surgeon innovators formal quality assessment of the included articles. A scoping are increasingly utilizing digital platforms and social media to review of currently available methods used to share learning in disseminate ideas and practice [12]. While this has notable surgery can identify potentially relevant digital methods, which benefits, the acquired knowledge is shared inconsistently in turn can inform the development of novel methods to optimize [13,14]. It may promote optimism bias by preferentially favoring shared learning in surgical innovation. positive developments and outcomes and is unsuited to building Aims and Objectives a robust evidence base [15]. Furthermore, approaches to disseminating information provide little or no scope for The aim of this scoping review is to explore the application of feedback, hindering efficient innovation that can address digital methods for training/education and feedback for shared learning curve effects. This may also mean the benefits and learning in the context of invasive surgical procedures. We harm outcomes of innovation are underreported or not shared aimed to: transparently, and opportunities to promote patient safety by Summarize existing methods for shared learning (ie, digital avoiding repetition of potentially harmful mistakes are therefore methods for learning or education and feedback) and how lost. Methods for effectively and transparently sharing they are characterized and operationalized information in real time are needed to accommodate incremental, https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 2 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al Examine the impact of the applications of methods for education and feedback in surgery can include but are not shared learning from data on the evaluation of methods limited to assessment of skills; performance or outcomes; Explore benefits and barriers to the implementation of proctorship, mentoring, apprenticeships; and demonstration of methods for shared learning from data on the evaluation of techniques and simulation. methods Digital Methods Results will inform strategies for embedding suitable methods Digital methods will be defined as utilizing electronic within an electronic platform for real-time reporting and sharing technology that is able to generate, store, and process data. In of outcomes of surgical innovation. this review, we will exclude any methods that are used in situ (eg, laparoscopic equipment that includes cameras to broadcast Methods to screens located in the operating theater). Overview Invasive Procedure A scoping review was chosen to investigate this topic due to An invasive procedure is defined as “one where the breadth and type of the data of interest for the research purposeful/deliberate access to the body is gained via an question. This scoping review will be conducted adhering to incision, percutaneous puncture, where instrumentation is used the PRISMA (Preferred Reporting Items for Systematic Reviews in addition to the puncture needle, or instrumentation via a and Meta-Analyses) extension for scoping reviews natural orifice. It begins when entry to the body is gained and (PRISMA-ScR) and established frameworks for conducting ends when the instrument is removed, and/or the skin is closed. scoping reviews [26,28-30]. An initially completed checklist Invasive procedures are performed by trained healthcare can be found in Multimedia Appendix 1 [28], and an updated professionals using instruments, which include, but are not checklist will be provided upon publication of results. Two limited to, endoscopes, catheters, scalpels, scissors, devices and trained reviewers will conduct the review, with input from a tubes” (pg 2) [32]. multidisciplinary team consisting of surgeons, methodologists, Surgical Innovation health services researchers, and social scientists. Any necessary There is no agreed definition of innovative surgical innovation deviations from the current protocol will be reported in the [21,22,33] and no validated methods to identify the phase of completed manuscript. evaluation retrospectively in the published literature. Innovative Ethical Considerations surgical procedures were therefore defined as those where Ethical approval for this scoping review was not required, authors self-report an invasive procedure as “new” or because it does not involve human participants, their tissue, “modified,” corresponding to phases 1, 2a, and 2b of the IDEAL data or samples or has ethical implications, as outlined in (Idea, Development, Exploration, Assessment, Long-term study) institutional policies including Section 2 of the University of framework [34,35]. Bristol's Ethics of Research Policy and Procedure. Identifying Relevant Articles Definitions Data Sources Shared Learning Scoping searches conducted to inform our study have confirmed There is no consensus definition of shared learning in the health that relevant information is contained in a variety of data sources care or surgical literature [31]. For the purposes of this review, beyond traditional peer-reviewed publications. A number of we have defined shared learning as a method of providing different data sources are proposed to be of value for navigating training/education with feedback to 2 or more clinicians the unique landscape of available evidence and addressing the undertaking surgical procedures. Examples of training or study aim (Table 1). Table 1. Publication types considered in this review, with examples of possible data sources. Publication type Possible data sources (examples) Peer-reviewed publications Protocols, conference abstracts, empirical studies of any publication type (eg, pilot, feasibility, methodological, diag- nostic accuracy, intervention, and observational studies) Opinion pieces Editorials, comments, letters, perspectives, news, bulletins Social media Twitter posts, YouTube videos Gray literature Scientific, academic, government, or commercial reports (eg, reports of artificial intelligence or virtual reality systems) Commercial online resources Websites of manufacturers and platform/software/hardware providers related to training/education and feedback systems (eg, Johnson & Johnson, Medtronic, Proximie, Explorer Surgical, Visual Lab 360, Kognito, Oxford Medical Simulation, and Immersive Touch) librarian will aid optimization of searches and inclusivity of Searches search terms throughout. A total of 6 approaches will be followed to identify relevant data sources detailed above. Collaboration with a subject https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 3 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al and combined with Boolean search operators to retrieve relevant Electronic Database Searches content. A comprehensive search strategy for conducting electronic database searches will be developed. Keywords will be based Gray Literature on the study eligibility criteria using the search strings “shared A search of the gray literature will be conducted to identify learning” AND “methods” AND “invasive procedures.” potentially relevant articles not indexed in electronic databases. Targeted internet searches and relevant existing search strategies Specific sources to search for gray literature include OpenGrey, (eg, for invasive procedures [32]) will be used to inform the list Canada’s Drug and Health Technology Agency's Gray Matters, of keywords. Search strategies can be found in Multimedia Healthcare Management Information Consortium, National Appendix 2. Technical Information Service, and American Psychological The search strategy will be translated to search for relevant Association PsycExtra, and internet searches (eg, using Google). publications in MEDLINE (Ovid version) and Web of Science. Simple search terms will be used for these searches and adjusted based on gray literature sources and results. Any adjustments, Journal Searches if necessary, will be reported in the final manuscript. Scientific journals that are likely to publish relevant papers will Handsearching of Commercial Websites be searched manually to identify any peer-reviewed articles that may be missed through electronic database searches. Contents Websites of commercial providers of digital platforms or pages of journals will be reviewed with a date of publication software that are known to the research team will be searched within the last 5 years. Journals of interest will be identified to identify further relevant information on digital methods for through expert knowledge and journal databases (eg, Web of shared learning. Relevant websites of known surgical Science Master Journal List). Relevant journals identified a technologies and technology providers will include but are not priori include Journal of Medical Internet Research, BMJ limited to Proximie, Explorer Surgical, Visual Lab 360, Kognito, Surgery, Interventions & Health Technologies, Surgical Oxford Medical Simulation, Touch Surgery, Immersive Touch, Innovation, Health Information Research, Methods of Johnson & Johnson, and Medtronic. Commercial providers that Information in Medicine, and Applied Clinical Informatics. do not have product-ready solutions or are currently still in Additional journals from previously identified articles will be development and/or lack relevant publicly available data will added as appropriate. be excluded. Social Media Snowball Searches Social media platforms Twitter and YouTube have been One-layer forward snowball searches (citation mining) and identified as common sources for sharing knowledge about reverse snowballing (chain searching) will be applied to all surgical innovation [36] and will therefore serve as an additional included papers to capture related publications that may fall data source to inform the extent of their utility. Multiple different outside of the established search strategy. Any relevant review methods for querying social media platforms exist with known article (including systematic, scoping, literature, and narrative advantages and limitations [37]. Information will be searched reviews) identified through any of the above searches will be by entering keywords related to “surgery” (eg, surgical, retrieved and their reference lists screened for further potentially procedure) and “innovation” (eg, novel, improved, recently eligible records. developed, adapted) into the social media platforms’ own Study Eligibility advanced search functions (eg, Twitter application programming Study eligibility criteria are defined according to the Population, interface). These functions are free to use, providing access to Concept, and Context framework [38] and are presented in Table 1% of real-time content. Automated dashboard vendors provide 2. Publications will only be considered if they are dated within licensed software for the retrieval and analysis of social media 5 years of their original publication date to ensure data is content (eg, Mediatoolkit, Radian6). Dashboard vendors provide contemporary. Articles will also be excluded if they are not access to the full content of posts across a range of social media published in the English language, due to resource restrictions platforms. They will be considered to supplement searches if that prevent the translation of non-English articles. social media posts identified through advanced search functions are considered insufficient. The same keywords will be used https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 4 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al Table 2. Study eligibility criteria. Element Inclusion criteria Exclusion criteria Population Adult (>18 years) human population Individuals not qualified to undertake an invasive procedure • • Any individual qualified to undertake an invasive procedure (eg, medical students, undergraduates) (eg, junior doctors, surgeons, physicians, consultants, radiol- ogists, endoscopists, gastroenterologists, cardiologists, ad- vanced nurse practitioners) Concept Discuss, report, and/or evaluate one or more methods for Focus on digital method(s) for shared learning that are solely • • shared learning (ie, for training/education and feedback) aimed to be used in situ (eg, laparoscopic techniques that have Must utilize digital means for shared learning a camera installed and broadcast inside the operating theater) Quantitatively or qualitatively evaluate the method for shared Simple descriptive presentation of the method for shared • • learning learning Context Must be in the context of invasive procedures • • N/A N/A: not applicable. further information on their content (eg, presence of a link to Study Selection an external website). An initial data extraction form will be For records with common publication formats (ie, published a piloted with a small number of relevant articles (see Multimedia title, structured abstract, executive summary, or synopsis), a Appendix 3). The form will be iteratively refined to 2-stage screening process will be undertaken to assess records comprehensively capture all relevant detail emerging during for inclusion against the study eligibility criteria. the pilot. Search results will be downloaded from their respective online One review author will extract data from all included studies, databases, deduplicated, and uploaded to an online review and a second reviewer will independently perform double data manager (Rayyan) [39]. In a first step, 3 review authors (CH, extraction for at least 10% of articles. Consistency in the MK, and JR) will independently (each review author will be approach to data extraction will be ensured through constant blind to the screening choice of the others) screen the titles and dialogue between the 2 reviewers. abstracts, executive summaries, or synopses of the retrieved Data Analysis records, with 10% of records double-screened. Full texts of articles will be obtained from records meeting the inclusion Findings will be summarized in tables using descriptive statistics criteria and from those where inclusion remains uncertain (eg, and in narrative form. Verbatim extracted data will be analyzed because of a lack of information from the abstract). In a second by 2 reviewers adhering to principles of thematic analysis [40]. step, 2 reviewers will each screen half of the retrieved full texts Identified themes will be displayed in schematics. Any verbatim independently to assess full eligibility. Duplicate assessment extracted data will be reviewed to identify barriers and benefits of eligibility will be performed on 10% of all full texts with to the implementation of shared learning methods. Barriers will further duplicate reviews in case of poor agreement (<80%). be considered factors that impede the implementation of methods for shared learning in clinical practice. Benefits will It is anticipated that some potentially relevant records do not be considered those that enable implementation [41]. Two follow conventional publication formats (eg, tweets, opinion reviewers will code data as a barrier or benefit, whereby regular pieces, news articles). In this case, 2 reviewers will meetings will be held to discuss coding results, and senior independently review the content of the record in full. authors will be involved where consensus is required. In case Discrepancies at any stage of the screening process will initially an automated dashboard vendor is used to identify social media be discussed between the 2 review authors. A third independent posts, the content will undergo additional analysis using the reviewer (SP) will arbitrate where agreement on inclusion could software’s existing classification algorithms and analyses (eg, not be reached, and input from the wider team will be sought sentiment analysis). where necessary. Results Data Extraction This work was initiated in October 2021. Iterative refinements Data extraction will be performed directly into a purposely to the scoping review protocol and formalizing of methods were designed electronic data extraction form (eg, Microsoft Access; completed in January 2021. Targeted searches were conducted Microsoft Corp). Details about (1) study and publication in December 2021 to inform the development of a characteristics (eg, author, study design, funding, and comprehensive search strategy for electronic database searches. sponsorship statements), (2) the method for shared learning (eg, This strategy was iteratively developed for and tested in purpose, type, operationalization, and modality), and (3) impact MEDLINE. The final search was applied to MEDLINE and of methods for shared learning (eg, methodology of evaluating Web of Science in March 2022 and yielded a total of 10,093 methods for shared learning and their results, limitations, and records. Identification of relevant articles is currently ongoing author recommendations) will be extracted. Additional items and is expected to be completed by December 2022. Study of interest for social media posts will be explored to capture https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 5 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al selection, data extraction and analysis, and drafting of the efficiency and effectiveness of disseminating knowledge and manuscript to report the results of this scoping review will be information about novel procedures and devices. Essential to conducted throughout 2023. Open access peer-reviewed this ongoing work is the codevelopment of a real-time electronic publication is expected in 2023. Any changes to the methods platform that aims to collect, analyze, and feedback data about reported here will be documented and reported. novel procedures and devices. Such an electronic platform will host a range of evidence-based approaches to safe and Discussion transparent surgical innovation that can facilitate the standardized collection and sharing of information and This scoping review will explore methods for the application knowledge about novel procedures and devices [2,4]. Ultimately, of digital methods for training/education and feedback for shared enhancing shared learning in this way will reduce the risk of learning in the context of invasive surgical procedures. This avoidable patient harm and streamline the evaluation of work is, to the authors’ knowledge, the first to (1) summarize early-phase invasive procedures and devices. the application of existing methods for shared learning, (2) This work will adhere to a robust methodology following the examine the impact of their application, and (3) explore the recommended standards for conducting scoping reviews benefits and barriers to their implementation in the context of [26,28,29]. This will ensure transparency and reduced risk of surgery. This scoping review protocol outlines a total of 6 bias. Common limitations of scoping reviews, which also apply different approaches to identify relevant articles and data to to our work, should be noted. Searches will be restricted to the comprehensively map currently available information on this English language, which limits our ability to summarize and topic. examine findings from methods for shared learning in The results will provide an investigation of contemporary non–English-speaking contexts. Identifying surgical innovation methods, which will be of interest to health care professionals and related information is hindered by poor reporting and and methodologists wishing to adopt methods for shared informal dissemination. This work will intentionally address learning in surgical practice. Crucially, this work will contribute this challenge through an extensive search, but this may still to ongoing research that aims to optimize safe and transparent not be sufficient to exhaustively capture all existing work using innovation by promoting the sharing of incremental case-by-case literature synthesis methods. Electronic database searches will learning among surgeons performing new procedures. be limited to 2 databases. Expert advice was sought, and it is Knowledge sharing in surgical innovation has not yet received expected that most of the relevant information on shared learning much research attention, and there may be additional challenges is included in these databases. However, there is a possibility that need to be considered. For example, surgeon innovators that additional information of interest may be missed. may be reluctant to share ideas and might show hesitancy in In conclusion, this scoping review will enhance our knowledge light of potential impacts on confidentiality or reputation. There about the application of contemporary digital methods for is currently no evidence that demonstrates the underlying training/education and feedback for shared learning in the mechanisms that may impact surgeon innovators’ behavior context of invasive surgical procedures. This work is vital to toward sharing learning. This is an important avenue for future help inform the development of novel methods to optimize research requiring further exploration in qualitative work. shared learning in surgical innovation through the integration The findings from this scoping review will provide an initial of findings into an electronic platform for real-time reporting step to inform the development of strategies to improve the and sharing of outcomes related to surgical innovation. Acknowledgments This study was supported by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC) at University Hospitals Bristol and Weston National Health Service Foundation Trust and the University of Bristol (BRC-1215-20011). This work was supported by the Royal College of Surgeons of England Bristol Surgical Trials Centre. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR, the Royal College of Surgeons of England, or the Department of Health and Social Care. SP is an NIHR clinician scientist (NIHR CS-2016-16-019). NB is a Medical Research Council clinician scientist. JMB is an NIHR senior investigator. Data Availability This review will not generate any new data. All extracted data and results of the analyses will be made available as supplementary material in the publication of the review results. Authors' Contributions JMB, SP, KNLA, and NB developed the idea for this study. CH and MK prepared the protocol, which was reviewed, discussed, and approved by the entire study team. CH, MK, NA, and JR established and formulated the methods for this review, with input from RM, SP, KNLA, and SP. SP will provide general oversight for this study. SP, NB, and JMB will take the lead in implementing the findings from this study. https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 6 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al Conflicts of Interest JMB is a member of the Core Outcome Measures for Effectiveness Trials Initiative Management Group. All other authors declare no conflicts of interest. Multimedia Appendix 1 PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews) checklist. [PDF File (Adobe PDF File), 131 KB-Multimedia Appendix 1] Multimedia Appendix 2 Search strategy for database searches. [PDF File (Adobe PDF File), 145 KB-Multimedia Appendix 2] Multimedia Appendix 3 Initial list of data items to extract from eligible articles. [PDF File (Adobe PDF File), 127 KB-Multimedia Appendix 3] References 1. Barkun JS, Aronson JK, Feldman LS, Maddern GJ, Strasberg SM. Evaluation and stages of surgical innovations. The Lancet 2009 Sep 26;374(9695):1089-1096. [doi: 10.1016/S0140-6736(09)61083-7] [Medline: 19782874] 2. Hoffmann C, Hossaini S, Cousins S, Blencowe N, McNair AGK, Blazeby JM, et al. Reporting modifications in surgical innovation: a systematic scoping review protocol. Int J Surg Protoc 2021;25(1):250-256 [FREE Full text] [doi: 10.29337/ijsp.167] [Medline: 34825118] 3. Garas G, Cingolani I, Panzarasa P, Darzi A, Athanasiou T. Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery. PLoS One 2017 Aug 25;12(8):e0183332 [FREE Full text] [doi: 10.1371/journal.pone.0183332] [Medline: 28841648] 4. Avery K, Wilson N, Macefield R, McNair A, Hoffmann C, Blazeby J, et al. A Core Outcome Set for Seamless, Standardized Evaluation of Innovative Surgical Procedures and Devices (COHESIVE): a patient and professional stakeholder consensus study. Ann Surg 2021 Jun 07:2021. [doi: 10.1097/SLA.0000000000004975] [Medline: 34102667] 5. Dengler J, Padovano WM, Davidge K, McKay V, Yee A, Mackinnon SE. Dissemination and implementation science in plastic and reconstructive surgery: perfecting, protecting, and promoting the innovation that defines our specialty. Plast Reconstr Surg 2021 Feb 01;147(2):303e-313e. [doi: 10.1097/PRS.0000000000007492] [Medline: 33009331] 6. Ritala P, Olander H, Michailova S, Husted K. Knowledge sharing, knowledge leaking and relative innovation performance: An empirical study. Technovation 2015 Jan;35:22-31. [doi: 10.1016/j.technovation.2014.07.011] 7. Dhanaraj C, Parkhe A. Orchestrating innovation networks. AMR 2006 Jul;31(3):659-669. [doi: 10.5465/amr.2006.21318923] 8. Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. BMJ 1998 Aug 15;317(7156):465-468 [FREE Full text] [doi: 10.1136/bmj.317.7156.465] [Medline: 9703533] 9. Sanson-Fisher RW. Diffusion of innovation theory for clinical change. Med J Aust 2004 Mar 15;180(S6):S55-S56. [doi: 10.5694/j.1326-5377.2004.tb05947.x] [Medline: 15012582] 10. Rogers E, Singhal A, Quinlan M. Diffusion of innovations. In: Stacks DW, Salwen MB, Eichhorn KC, editors. An Integrated Approach to Communication Theory and Research, 2nd ed. New York, NY: Routledge; 2008:432-448. 11. Pandey J, Gupta M, Behl A, Pereira V, Budhwar P, Varma A, et al. Technology-enabled knowledge management for community healthcare workers: The effects of knowledge sharing and knowledge hiding. J Bus Res 2021 Oct;135:787-799. [doi: 10.1016/j.jbusres.2021.07.001] 12. Ahmed YA, Ahmad MN, Ahmad N, Zakaria NH. Social media for knowledge-sharing: A systematic literature review. Telemat 2019 Apr;37:72-112. [doi: 10.1016/j.tele.2018.01.015] 13. Dimick JB, Sedrakyan A, McCulloch P. The IDEAL framework for evaluating surgical innovation: how it can be used to improve the quality of evidence. JAMA Surg 2019 Aug 01;154(8):685-686. [doi: 10.1001/jamasurg.2019.0903] [Medline: 31166583] 14. Arroyo NA, Gessert T, Hitchcock M, Tao M, Smith CD, Greenberg C, et al. What promotes surgeon practice change? A scoping review of innovation adoption in surgical practice. Ann Surg 2021 Mar 01;273(3):474-482. [doi: 10.1097/SLA.0000000000004355] [Medline: 33055590] 15. Wang Y, McKee M, Torbica A, Stuckler D. Systematic literature review on the spread of health-related misinformation on social media. Soc Sci Med 2019 Nov;240:112552 [FREE Full text] [doi: 10.1016/j.socscimed.2019.112552] [Medline: 31561111] https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 7 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al 16. Sánchez-González P, Cano AM, Oropesa I, Sánchez-Margallo FM, Del Pozo F, Lamata P, et al. Laparoscopic video analysis for training and image-guided surgery. Minim Invasive Ther Allied Technol 2011 Dec;20(6):311-320. [doi: 10.3109/13645706.2010.541921] [Medline: 21247251] 17. Lui TK, Wong KK, Mak LL, To EW, Tsui VW, Deng Z, et al. Feedback from artificial intelligence improved the learning of junior endoscopists on histology prediction of gastric lesions. Endosc Int Open 2020 Feb 22;8(2):E139-E146 [FREE Full text] [doi: 10.1055/a-1036-6114] [Medline: 32010746] 18. Artsen AM, S Burkett L, Duvvuri U, Bonidie M. Surgeon satisfaction and outcomes of tele-proctoring for robotic gynecologic surgery. J Robot Surg 2022 Jun 16;16(3):563-568 [FREE Full text] [doi: 10.1007/s11701-021-01280-x] [Medline: 34272656] 19. Gurusamy K, Aggarwal R, Palanivelu L, Davidson BR. Systematic review of randomized controlled trials on the effectiveness of virtual reality training for laparoscopic surgery. Br J Surg 2008 Sep;95(9):1088-1097. [doi: 10.1002/bjs.6344] [Medline: 18690637] 20. Larsen CR, Oestergaard J, Ottesen BS, Soerensen JL. The efficacy of virtual reality simulation training in laparoscopy: a systematic review of randomized trials. Acta Obstet Gynecol Scand 2012 Sep;91(9):1015-1028 [FREE Full text] [doi: 10.1111/j.1600-0412.2012.01482.x] [Medline: 22693954] 21. Birchley G, Ives J, Huxtable R, Blazeby J. Conceptualising surgical innovation: an eliminativist proposal. Health Care Anal 2020 Mar;28(1):73-97 [FREE Full text] [doi: 10.1007/s10728-019-00380-y] [Medline: 31327091] 22. Hutchison K, Rogers W, Eyers A, Lotz M. Getting clearer about surgical innovation: a new definition and a new tool to support responsible practice. Ann Surg 2015 Dec;262(6):949-954. [doi: 10.1097/SLA.0000000000001174] [Medline: 25719812] 23. Macefield R, Wilson N, Hoffmann C, Blazeby J, McNair A, Avery K, et al. Outcome selection, measurement and reporting for new surgical procedures and devices: a systematic review of IDEAL/IDEAL-D studies to inform development of a core outcome set. BJS Open 2020 Oct 04;4(6):1083 [FREE Full text] [doi: 10.1002/bjs5.50358] [Medline: 33016009] 24. Hoffmann C, Macefield RC, Wilson N, Blazeby JM, Avery KNL, Potter S, et al. A systematic review and in-depth analysis of outcome reporting in early phase studies of colorectal cancer surgical innovation. Colorectal Dis 2020 Dec 23;22(12):1862-1873. [doi: 10.1111/codi.15347] [Medline: 32882087] 25. Sharma D, Harris M, Agrawal V, Agarwal P. Plea for standardised reporting of frugal innovations. BMJ Innov 2021 Sep 13;7(4):642-646. [doi: 10.1136/bmjinnov-2021-000710] 26. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005 Feb;8(1):19-32. [doi: 10.1080/1364557032000119616] 27. Rumrill PD, Fitzgerald SM, Merchant WR. Using scoping literature reviews as a means of understanding and interpreting existing literature. Work 2010;35(3):399-404. [doi: 10.3233/WOR-2010-0998] [Medline: 20364059] 28. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, Tunçalp, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018 Oct 02;169(7):467-473. [doi: 10.7326/M18-0850] [Medline: 30178033] 29. Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci 2010;5:69 [FREE Full text] [doi: 10.1186/1748-5908-5-69] [Medline: 20854677] 30. Tricco AC, Lillie E, Zarin W, O'Brien K, Colquhoun H, Kastner M, et al. A scoping review on the conduct and reporting of scoping reviews. BMC Med Res Methodol 2016 Feb 09;16:15 [FREE Full text] [doi: 10.1186/s12874-016-0116-4] [Medline: 26857112] 31. Cannavina G, Wood D, Winstanley RB, Walsh TF. A retrospective study of shared learning on the BMedSci Dental Technology course at The University of Sheffield. Eur J Dent Educ 2000 Nov;4(4):160-164. [doi: 10.1034/j.1600-0579.2000.040403.x] [Medline: 11168481] 32. Cousins S, Blencowe NS, Blazeby JM. What is an invasive procedure? A definition to inform study design, evidence synthesis and research tracking. BMJ Open 2019 Jul 30;9(7):e028576 [FREE Full text] [doi: 10.1136/bmjopen-2018-028576] [Medline: 31366651] 33. Rogers W, Lotz M, Hutchison K, Pourmoslemi A, Eyers A. Identifying surgical innovation: a qualitative study of surgeons' views. Ann Surg 2014 Feb;259(2):273-278. [doi: 10.1097/SLA.0b013e31829ccc5f] [Medline: 23787218] 34. McCulloch P, Cook JA, Altman DG, Heneghan C, Diener MK, IDEAL Group. IDEAL framework for surgical innovation 1: the idea and development stages. BMJ 2013 Jun 18;346:f3012 [FREE Full text] [doi: 10.1136/bmj.f3012] [Medline: 23778427] 35. Ergina PL, Barkun JS, McCulloch P, Cook JA, Altman DG, IDEAL Group. IDEAL framework for surgical innovation 2: observational studies in the exploration and assessment stages. BMJ 2013 Jun 18;346:f3011 [FREE Full text] [doi: 10.1136/bmj.f3011] [Medline: 23778426] 36. Bennett KG, Berlin NL, MacEachern MP, Buchman SR, Preminger BA, Vercler CJ. The ethical and professional use of social media in surgery: a systematic review of the literature. Plast Reconstr Surg 2018 Sep;142(3):388e-398e [FREE Full text] [doi: 10.1097/PRS.0000000000004692] [Medline: 30148789] 37. Kim AE, Hansen HM, Murphy J, Richards AK, Duke J, Allen JA. Methodological considerations in analyzing Twitter data. J Natl Cancer Inst Monogr 2013 Dec;2013(47):140-146. [doi: 10.1093/jncimonographs/lgt026] [Medline: 24395983] https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 8 (page number not for citation purposes) XSL FO RenderX JMIR RESEARCH PROTOCOLS Hoffmann et al 38. Peters MDJ, Godfrey C, McInerney P, Munn Z, Trico AC, Khalil H. Chapter 11: Scoping reviews. JBI Manual for Evidence Synthesis. 2020. URL: https://doi.org/10.46658/JBIMES-20-01 [accessed 2022-08-11] 39. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016 Dec 05;5(1):210 [FREE Full text] [doi: 10.1186/s13643-016-0384-4] [Medline: 27919275] 40. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006 Jan;3(2):77-101. [doi: 10.1191/1478088706qp063oa] 41. Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci 2015;10:53 [FREE Full text] [doi: 10.1186/s13012-015-0242-0] [Medline: 25895742] Abbreviations BRC: Biomedical Research Centre IDEAL: Idea, Development, Exploration, Assessment, Long-term study NIHR: National Institute for Health and Care Research PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA-ScR: PRISMA extension for scoping reviews Edited by T Leung; submitted 24.02.22; peer-reviewed by L Irgang, K Matthias, K Mears; comments to author 04.08.22; revised version received 11.08.22; accepted 16.08.22; published 08.09.22 Please cite as: Hoffmann C, Kobetic M, Alford N, Blencowe N, Ramirez J, Macefield R, Blazeby JM, Avery KNL, Potter S Shared Learning Utilizing Digital Methods in Surgery to Enhance Transparency in Surgical Innovation: Protocol for a Scoping Review JMIR Res Protoc 2022;11(9):e37544 URL: https://www.researchprotocols.org/2022/9/e37544 doi: 10.2196/37544 PMID: ©Christin Hoffmann, Matthew Kobetic, Natasha Alford, Natalie Blencowe, Jozel Ramirez, Rhiannon Macefield, Jane M Blazeby, Kerry N L Avery, Shelley Potter. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 08.09.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included. https://www.researchprotocols.org/2022/9/e37544 JMIR Res Protoc 2022 | vol. 11 | iss. 9 | e37544 | p. 9 (page number not for citation purposes) XSL FO RenderX

Journal

JMIR Research ProtocolsJMIR Publications

Published: Sep 8, 2022

Keywords: innovation; surgery; surgical; shared learning; scoping review; operative; procedures; digital; training; learning; feedback; digital method; review; review methodology; surgeon; education; medical education; eHealth; digital health; digital tool

There are no references for this article.