Digital learning and remote technical support enhancing continuous education in endovascular surgery. Technical aspects and user satisfaction.

Objectives Remote teaching is nowadays incorporated into vascular surgery education, with its adoption accelerated by COVID-19 pandemic. However, the technical and human factors that determine user satisfaction with this remote learning modality remain poorly characterised. This study aimed to identify the determinants of user satisfaction during remote broadcasts of endovascular procedures. Methods This was a prospective observational multicentre study. Fourteen consecutive endovascular procedures have been broadcasted via the OneViewX system(SparkBioSrl, San Lazzaro-Bologna, Italy) between February 2023 and June 2024. One hundred participants (47 residents, 53 clinical application specialists) attended remotely. Objective transmission metrics (speed, latency, instability, frame-rate) and subjective evaluations (video/audio quality/fluidity, interaction) were recorded. Predefined technical cut-offs and quartile thresholds defined suboptimal performance. The primary endpoint was the participant's overall educational experience (satisfactory vs. moderate/flawed vs. unsatisfactory). Secondary endpoints included the identification of factors associated with moderate/flawed evaluations. Results Among 182 attendees, 100 questionnaires were returned (69 aortic, 31 peripheral cases). Participants accessed broadcasts via smartphone or personal computers (40 vs.60), with 68 using WiFi and 32 mobile networks. Overall, 85% of participants rated the experience fully satisfactory, 15% moderately satisfactory, and none unsatisfactory. Objective parameters, as speed, latency, instability, and frame rate, were not associated with user satisfaction, even when below technical/lowest performance cut-off values. Subjectively, by 18 responders cases were rated as having flawed video quality, 22 pointed out flawed video fluidity, 12 flawed audio quality, 14 flawed video set-up, 12 reported flawed audio interaction with operators. At univariate analysis, flawed video quality(p=.016); flawed video fluidity(p<.001) and flawed audio interaction ( p<.001) were associated with moderate satisfaction at final evaluation. Logistic regression identified lack in video fluidity as independent predictor(p=.027; odds-ratio =4.85, 95%confidence-interval=1.20–19.64) of moderate satisfactory evaluation. Conclusion Remote digital broadcasting represents a reliable modality for endovascular education and technical support in vascular surgery, using standard digital infrastructure. User satisfaction depended primarily on video fluidity and interactivity rather than objective transmission metrics, suggesting that tele-mentoring systems should prioritize human experience alongside technical performance.