The Feasibility and Efficacy of Video Education with Individual Review in Early Surgical Education

Abstract

Purpose

Use of video-based education (VBE) to teach surgical skills has increased rapidly and been shown to accelerate students’ and residents’ time to satisfactory skill acquisition while also improving trainees’ satisfaction. However, its implementation is limited by logistical factors such as: video quality, view obstruction, and excessive motion. We aim to study the feasibility of using VBE to teach medical students basic suturing skills.

Methods

Medical students viewed standardized videos to learn multiple suturing techniques, which they performed on a skin model. They recorded and sent their best attempt at subcuticular technique to a plastic surgery resident who provided synchronous, virtual feedback. Following feedback, students re-attempted the technique and again recorded their best attempt. Both videos were graded by a blinded reviewer. A previously-validated grading scale was used to score students on 1) number of completed suturing steps, 2) economy of time and motion, and 3) final rating (proficient or requires practice).

Results

All fifteen students agreed that this activity was either “fairly” or “very” useful for their learning. Seven students were rated as proficient prior to feedback and remained proficient following feedback. Of the remaining eight students, five students (62.5%) achieved proficiency following feedback. On average, the students demonstrated significant improvement in number of successfully completed suture steps (4.3 ± 1.10 vs 4.8 ± 1.01 post-feedback, p = 0.028) and economy of time and motion (2.6 ± 1.24 vs 3.2 ± 0.94 post-feedback, p = 0.029). When adjusting for student interest in pursuing a surgical residency, baseline scores were similar, but those who intend to pursue surgery demonstrated greater economy of motion scores following feedback (3.56 ± 0.73 vs 2.67 ± 1.03 among students not interested in surgery, p = 0.035).

Conclusions

This pilot study shows that use of VBE is feasible in teaching medical students basic suturing skills. Efficacy may be influenced by career interests.