Practice using computer-based video instruction (CBVI) leads to improvements in surgical skills proficiency. This study investigated the benefits of the introduction of (a) learner-directed, interactive video training and (b) the addition of expert instruction on the learning and retention of the basic surgical skills of suturing and knot-tying in medical students.
Using bench models, students were pre-tested on a suturing and knot-tying skill after viewing an instructional video. The students were then randomly assigned to three practice conditions: self-study with video; self-study with interactive video; or the combination of self-study with interactive video with the addition of subsequent expert instruction. All participants underwent 18 trials of practice in their assigned training condition. The effectiveness of training was assessed by an immediate post-test and a retention test one month later. Performance was evaluated using expert- and computer-based assessments. Data were analyzed using repeated-measures ANOVA.
There were no differences in expert- and computer-based assessments between groups at pre-test. Although all three groups demonstrated significant improvements on both measures between the pre- and post-tests as well as between pre-tests and retention-tests (P < .01), no significant differences were detected among the three groups.
This study shows that in surgical novices, neither the inclusion of expert instruction nor the addition of self-directed interaction with video leads to further improvements in skill development or retention. These findings further support the possible implementation of CBVI within surgical skills curricula.
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- Simulation and clinical practice: strengthening the relationship.Med Educ. 2004; 38: 1095-1102
- New approaches to learning clinical skills.Med Educ. 2004; 38: 1021-1023
- Computer assisted learning in undergraduate medical education.Br Med J. 2001; 322: 40-44
- Teaching suturing and knot-tying skills to medical students: a randomized controlled study comparing computer-based video instruction and (concurrent and summary) expert feedback.Surgery. 2007; 141: 442-449
- Acquisition of surgical skills: a randomized trial of didactic, videotape, and computer-based training.Surgery. 1999; 126: 330-336
- Virtual reality training improves operating room performance: results of a randomized, double-blinded study.Ann Surg. 2002; 236: 458-463
- Computer-mediated instructional video: a randomized controlled trial comparing a sequential and a segmented instructional video in surgical hand wash.Eur J Dent Educ. 2005; 9: 53-58
- Learner-control vs. program-control instructional multimedia: a comparison of two interactions when teaching principles of orthodontic appliances.Eur J Dent Educ. 2005; 9: 157-163
- Surgical skill acquisition with self-directed practice using computer-based video training.Am J Surg. 2007; 193: 237-242
- The impact of external feedback on computer-assisted learning for surgical technical skill training.Am J Surg. 2000; 179: 341-343
- Performance vs. learning curves: what is motor learning and how is it measured?.Surg Endosc. 2005; 19: 1290-1291
- Verbal feedback from an expert is more effective than self-assessed feedback about motion efficiency in learning new surgical skills.Am J Surg. 2007; 193: 105-110
- The relationship between motion analysis and surgical technical assessments.Am J Surg. 2002; 184: 70-73
- Construct validity of computer-assisted assessment: quantification of movement processes during a vascular anastomosis.Am J Surg. 2007; 193: 523-529
- Computer assisted assessment of one-handed knot tying skills at varying complexity levels: A construct validity study.Am J Surg. 2006; 192: 109-113
- Challenge Point: a framework for conceptualizing the effects of various practice conditions in motor learning.J Mot Behav. 2004; 36: 212-224
Issenberg SB, Cook D, Ker J. Simulation in medical education. Proceedings to Association for Medical Education in Europe 2006. p. 29.
Published online: January 31, 2008
Accepted: October 25, 2007
Supported in part by the Dean's Excellence Fund, Department of Surgery, University of Toronto.
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.