TY - JOUR
T1 - One Step at a Time
T2 - Step by Step Versus Continuous Video-Based Learning to Prepare Medical Students for Performing Surgical Procedures
AU - Nazari, Tahmina
AU - van de Graaf, Floyd W.
AU - Dankbaar, Mary E. W.
AU - Lange, Johan F.
AU - van Merrienboer, Jeroen J. G.
AU - Wiggers, Theo
N1 - Publisher Copyright:
© 2020 Association of Program Directors in Surgery
PY - 2020
Y1 - 2020
N2 - OBJECTIVE: The objective of this study was to compare the effects of cognitive load and surgical performance in medical students that performed the open inguinal hernia repair after preparation with step-by-step videodemonstration versus continuous video-demonstration. Hypothetically, the step-by-step group will perceive lower extraneous load during the preparation of the surgical procedure compared to the continuous group. Subsequently, fewer errors will be made in the surgical performance assessment by the step-by-step group, resulting in better surgical performance.DESIGN: In this prospective study, participants were randomly assigned to the step-by-step or continuous video-demonstration. They completed questionnaires regarding perceived cognitive load during preparation (10-point Likert scale). Their surgical performance was assessed on a simulation hernia model using the Observational Clinical Human Reliability Assessment.SETTING: Erasmus University Medical Center, Rotterdam, the Netherlands.PARTICIPANTS: Participants included medical students who were enrolled in extracurricular anatomy courses.RESULTS: Forty-three students participated; 23 students in the step-by-step group and 20 in the continuous group. As expected, the step-by-step group perceived a lower extraneous cognitive load (2.92 +/- 1.21) compared to the continuous group (3.91 +/- 1.67, p = 0.030). The surgical performance was not statistically significantly different between both groups; however, in subanalyses on a selection of students that prepared for 1 to 2 hours, the step-by-step group made less procedural errors, 1.67 +/- 1.11, compared to the continuous group, 3.06 +/- 1.91, p = 0.018.CONCLUSIONS: Our results suggest that preparation using step-by-step video-based learning results in lower extraneous cognitive load and subsequently fewer procedural errors during the surgical performance. For learning purposes, demonstration videos of surgical procedures should be presented in a segmented format. (C) 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
AB - OBJECTIVE: The objective of this study was to compare the effects of cognitive load and surgical performance in medical students that performed the open inguinal hernia repair after preparation with step-by-step videodemonstration versus continuous video-demonstration. Hypothetically, the step-by-step group will perceive lower extraneous load during the preparation of the surgical procedure compared to the continuous group. Subsequently, fewer errors will be made in the surgical performance assessment by the step-by-step group, resulting in better surgical performance.DESIGN: In this prospective study, participants were randomly assigned to the step-by-step or continuous video-demonstration. They completed questionnaires regarding perceived cognitive load during preparation (10-point Likert scale). Their surgical performance was assessed on a simulation hernia model using the Observational Clinical Human Reliability Assessment.SETTING: Erasmus University Medical Center, Rotterdam, the Netherlands.PARTICIPANTS: Participants included medical students who were enrolled in extracurricular anatomy courses.RESULTS: Forty-three students participated; 23 students in the step-by-step group and 20 in the continuous group. As expected, the step-by-step group perceived a lower extraneous cognitive load (2.92 +/- 1.21) compared to the continuous group (3.91 +/- 1.67, p = 0.030). The surgical performance was not statistically significantly different between both groups; however, in subanalyses on a selection of students that prepared for 1 to 2 hours, the step-by-step group made less procedural errors, 1.67 +/- 1.11, compared to the continuous group, 3.06 +/- 1.91, p = 0.018.CONCLUSIONS: Our results suggest that preparation using step-by-step video-based learning results in lower extraneous cognitive load and subsequently fewer procedural errors during the surgical performance. For learning purposes, demonstration videos of surgical procedures should be presented in a segmented format. (C) 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
KW - medical education
KW - surgery
KW - inguinal hernia repair
KW - step by step teaching
KW - stepwise
KW - segmentation
KW - COGNITIVE ARCHITECTURE
U2 - 10.1016/j.jsurg.2020.02.020
DO - 10.1016/j.jsurg.2020.02.020
M3 - Article
C2 - 32171749
SN - 1931-7204
VL - 77
SP - 779
EP - 787
JO - Journal of Surgical Education
JF - Journal of Surgical Education
IS - 4
ER -