Computer-assisted Learning versus a Lecture and Feedback Seminar for Teaching a Basic Surgical Technical Skill

doi:10.1016/S0002-9610(98)00087-7

The American Journal of Surgery

Volume 175, Issue 6, June 1998, Pages 508-510

https://doi.org/10.1016/S0002-9610(98)00087-7 Get rights and content

Abstract

Background: Rapid improvements in computer technology allow us to consider the use of computer-assisted learning (CAL) for teaching technical skills in surgical training. The objective of this study was to compare in a prospective, randomized fashion, CAL with a lecture and feedback seminar (LFS) for the purpose of teaching a basic surgical skill.

Methods: Freshman medical students were randomly assigned to spend 1 hour in either a CAL or LFS session. Both sessions were designed to teach them to tie a two-handed square knot. Students in both groups were given knot tying boards and those in the CAL group were asked to interact with the CAL program. Students in the LFS group were given a slide presentation and were given individualized feedback as they practiced this skill. At the end of the session the students were videotaped tying two complete knots. The tapes were independently analyzed, in a blinded fashion, by three surgeons. The total time for the task was recorded, the knots were evaluated for squareness, and each subject was scored for the quality of performance.

Results: Data from 82 subjects were available for the final analysis. Comparison of the two groups demonstrated no significant difference between the proportion of subjects who were able to tie a square knot. There was no difference between the average time required to perform the task. The CAL group had significantly lower quality of performance (t = 5.37, P <0.0001).

Conclusions: CAL and LFS were equally effective in conveying the cognitive information associated with this skill. However, the significantly lower performance score demonstrates that the students in the CAL group did not attain a proficiency in this skill equal to the students in the LFS group. Comments by the students suggest that the lack of feedback in this model of CAL was the significant difference between these two educational methods.

Section snippets

Method

Approval was obtained from the IRB at the Medical College of Georgia. Freshman students were enrolled in the study, and each was randomly assigned to either the CAL or LFS session. There were 10 to 12 students in each group. Each student was given a knot tying board and tying rope. The students were not paid for participating in the study but were allowed to keep the knot tying board and rope.

In the LFS session, a series of 2 × 2 photographic slides was used to demonstrate the skill of tying a

Results

Ninety-one freshman medical students were enrolled in the study. Eight of the subjects were excluded because they had previous experience in the operating room or emergency room. The data from 1 of the subjects was excluded because it was not possible to evaluate the task on the videotape, leaving data from 82 of the students available for analysis. A total of 40 students participated in the CAL session and 42 students participated in the LFS session. Average age, gender distribution,

Comment

A similar proportion of students in both groups were able to tie a square knot, suggesting that both groups grasped the cognitive portion of the task. By contrast, the significant difference in performance scores indicates that students in the LFS group attained a significantly higher level of proficiency with the skill than students in the CAL group. The finding of equivalence of cognition between the two methods is consistent with the existing literature on the use of CAL in medical education.

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Citation Excerpt :
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¹: Presented at the 17th Annual Meeting of the Association for Surgical Education, Philadelphia, Pennsylvania, April 9–12, 1997.

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Association for Surgical EducationComputer-assisted Learning versus a Lecture and Feedback Seminar for Teaching a Basic Surgical Technical Skill 1

Abstract

Section snippets

Method

Results

Comment

Am J Surg

Am J Surg

Teaching (and using) surgical technique

Curr Surg

Anastomosisa craft workshop for surgical trainees

Aust N Z J Surg

Ten-year experience with a basic technical skills and perioperative management workshop for first-year residents

Can J Surg

The anastomosis workshop, March 1981

Ann R Coll Surg Engl

A technical-skills course for 1st-year residents in general surgerya descriptive study

Can J Surg

Halstedian technique revisitedinnovations in teaching surgical skills

Ann Surg

Association for Surgical Education
Computer-assisted Learning versus a Lecture and Feedback Seminar for Teaching a Basic Surgical Technical Skill ¹