Black Belt Academy of Surgical Skills was set up with the aim of teaching and training basic surgical skills, allowing trainees to hone their skills from the comfort of their own homes, across the globe. We had the honour of talking to founder David O'Regan about the inspiration behind BBASS, how he leverages virtual platforms for global reach, and the importance of always starting with the basics
We’d love to know more about the BBASS story, how did it begin?
The idea came about nine years ago when my son wanted to join a martial arts academy. The academy encouraged me to get involved too and, at 61, I was a student again in a room of people aged 13 — from red belts, white belts, all the way to advanced Dans. We were all doing the basics, again and again. We practised until we could not get it wrong.
Just before I did my third Dan, there was one particular move that caused me problems. The Sensei taking the class broke it down into the basics. During my 15 years of surgical training, the number of surgeons who were able to deconstruct the movement of operating is three. Only these three had the capacity and patience to explain ‘if you stand on the right foot, angle the needle this way, put your elbow up you can do it’.
This is what I am trying to do with my BBASS teaching sessions. I've taken all the basic skills and deconstructed them into principles. I explain the instruments and how to hold them to maximise the feel of the tissues. Not many explain the lightness of touch that is required to operate or offer the appropriate models to test this skill. I focus on flow, rhythm and feel. I call it diastolic learning.
How do you manage to teach practical skills in a virtual format?
Before Covid, I wouldn't have conceived of doing this, but now I'm one of the few people teaching surgical skills online and demonstrating how to do the skills. I use low fidelity models to encourage people to practise at home. For example, in one of the teaching sessions I ran, we cut a pepper in half and had a straw on either side. You have to reach into the pepper, with each hand, and pick out the pips and put them in the straws. I have received many photos from the global audience showing me their novel models. People are engaged.
How has MedAll helped BBASS?
MedAll has made teaching easier, more interactive and more reliable. I believe teaching surgical skills live adds a new dimension - I can make errors on the models and explain why and how to avoid them. I can tell stories, of which I have many, and the sessions feel real and not formulaic or stage managed.
The platform enables conversation with the audience as they can ask questions by typing in the chat; I am very happy to be interrupted. I am certainly learning from every session and my attendees offer regular critical feedback.
MedAll's audience is medics and surgeons around the world. Facebook had a bigger reach, but it wasn’t focused. I ended up paying for a promotion on Facebook to reach a target audience, but with MedAll it's already done. This is fantastic.
"MedAll offers automated certificates, which are linked to the feedback questionnaires on each of my teaching sessions. All of the BBASS videos are collected on MedAll, so when you view my Organisation, you can see everything I've done and have the opportunity to replay or catch up."
The ability to pose questions to the audience as they register is also useful so I can assess their level of knowledge and understanding. I'm able to view a range of statistics and demographics of the audience including countries, cities, speciality and roles. In the past, I had to do this manually with Facebook, but on MedAll it’s automatic.
I'm only beginning to touch the surface of the potential of the MedAll platform — my imagination is running wild.
How do you use social media alongside MedAll to give BBASS a global reach?
The BBASS audience follow, interact and send messages on Facebook, Twitter and Instagram. What is lovely is when people send photographs on Twitter of what they're doing during my teaching sessions. Recently, we ran a banana stitching competition and had entries from all around the world. I have had the pleasure of posting instruments as prizes to the winners who were based in Romania, Lithuania, Abu Dhabi, and Derby in the UK. That was just fantastic.
What’s next for BBASS?
I'm hoping to start a movement. People are so excited about new technologies, new lenses, VR, robotics, but what happens when you’re a surgeon and something goes wrong? You have to go in; it becomes open surgery. Tech is exciting, but mastering skills is crucial. This begins with understanding the basics. Everything comes back to the basics. If you ever run into difficulty, good basics enable critical thinking under pressure. It is essential to strip it all back.
I’m trying to change the world, by thinking about how we teach and train basic skills. Why are we teaching people to operate sitting down? This is akin to teaching someone to play golf sitting down.
"Why are we teaching people to operate sitting down? This is akin to teaching someone to play golf sitting down."
The colleges of surgeons run basic skills courses, but these are expensive. BBASS wants to stimulate people to practice and improve. It must be fun. And free. People can practice at home with very little extra equipment or cost. Only twenty minutes a day.
As MedAll grows, I hope to grow, and with BBASS being on a global platform like MedAll, we'll continue to enable people to ‘home’ their surgical skills.