[Comparative Analysis of Conventional and Blended-Learning Teaching Techniques for a Skills Lab Course on Local Flaps].

Abstract

Purpose: A practical course on local flap surgery was developed for students who had completed the curricular suture course. During the COVID-19 pandemic, the course design was modified to control contact times through didactic adjustments. The aim of this study was to analyse the influence of the teaching method on the theoretical and practical skills of course participants, comparing conventional face-to-face instruction with blended-learning teaching techniques.

Methods: The data were collected prospectively and anonymously between January 2022 and November 2024. In the conventional course [n=44], an introductory lecture was held in person at the beginning of the course to explain the anatomical and surgical principles of the four flap procedures before each flap surgery was demonstrated in an instructional video. The blended-learning group [n=57] received this lecture and the surgical videos online for self-study prior to the course. The students in both groups practiced each of the four techniques independently on an ex-vivo porcine back specimen under the supervision of two tutors. After the completion of all surgical exercises, each student's surgical performance was assessed both by the student and by the two tutors using the Stanford Microsurgery and Resident Training (SMaRT) scale after completing all surgical exercises.This was followed by a quiz featuring clinical cases, in which the surgical procedure was discussed within the group. Afterwards, the theoretical knowledge was assessed with ten multiple-choice (MC) questions. At the end of the course, all participants completed an evaluation form containing questions on prior knowledge, course structure, and learning outcomes.

Results: No significant differences were observed between the two groups in terms of theoretical and practical knowledge, learning outcomes, the MC exam, the SMaRT questionnaire, and course organisation. The conventional teaching method group (29.9%) reported significantly more often that they did not have enough time to practice the flap techniques during the course compared with the blended-learning group (17.5%; p=0.023).

Conclusion: Performing local flaps independently improves students' surgical skills for reconstruction of soft tissue defects. Thus, a skills lab is an appropriate learning institution for surgical skills. Both teaching methods lead to comparable theoretical and practical learning effects. Consequently, the blended-learning technique is recommended for a practical course, as it allows more time for surgical exercises.