The Impact of Video-Coached Laparoscopic Simulation Training on Entrustable Professional Activities in Surgical Residents

Background Modern medical education is transitioning toward competency-based models, with Entrustable Professional Activities (EPAs) serving as a core framework for assessing clinical competencies. This study evaluates the impact of a video coaching–based laparoscopic simulation training model on surgical residents’ operative skills, EPAs, and cognitive load. Methods A randomized controlled trial was conducted with 42 urology residents at the First Affiliated Hospital of Sun Yat-sen University. Participants were divided into control and experimental groups. The control group received conventional laparoscopic training, while the experimental group underwent additional video coaching, including standardized teaching video instruction, self-review of practice recordings, and targeted feedback. Assessments included the Global Operative Assessment of Laparoscopic Skills (GOALS), traditional laparoscopic skills scores, Surgical Task Load Index (SURG-TLX), and SimBall Box scores. Results The experimental group demonstrated significantly higher GOALS scores (17.50 ± 2.20) compared to the control group (12.50 ± 1.60) (P < 0.05). SimBall Box scores also improved significantly in the experimental group (41.50 ± 5.49 vs. 36.75 ± 3.22, P < 0.05). While the experimental group initially exhibited higher cognitive load (SURG-TLX: 37.75 ± 6.07 vs. 14.50 ± 3.89, P < 0.05), post-training cognitive load was comparable between groups (28.00 ± 7.67 vs. 23.00 ± 3.85, P > 0.05). No significant differences were observed in traditional laparoscopic skills scores or free training time. Conclusion Video coaching significantly enhances laparoscopic skills and EPA entrustable level among surgical residents, supported by improved GOALS and SimBall Box scores. The model’s ability to reduce long-term cognitive load and foster self-directed learning underscores its potential for broader application in competency-based medical education (CBME). Future research should explore higher-dimensional skill stratification and larger-scale validation to optimize this approach.