We established an interactive digital video link between specialists at Flinders University, South Australia and Kyushu University, Japan, with a third site at the National University of Singapore. The system provided standard definition, non-compressed video at 30 frames per second and required 32 Mbit/s bandwidth per bidirectional connection. The quality of the surgical images was sufficient to allow surgeons at remote sites to develop a good idea of the surgical technique, and there was general agreement that this was a viable tool for remote surgical training. The images and interactions were significantly better than those typical of conventional videoconferencing. The challenge now is to develop structured education sessions utilising additional materials to supplement the surgical sessions, and to develop an appropriate pedagogical framework for this form of learning.
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