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      Video-based instructions for surgical hand disinfection as a replacement for conventional tuition? A randomised, blind comparative study Translated title: Videobasierte Instruktionen zur chirurgischen Händedesinfektion als Ersatz für konventionellen Unterricht? Eine randomisierte, geblendete Vergleichsstudie

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          Abstract

          Introduction: Various different learning methods are available for planning tuition regarding the introduction to surgical hand disinfection. These learning methods should help to organise and deal with this topic. The use of a video film is an alternative to conventional tuition due to the real presentation possibilities of practical demonstration.

          Objective: This study examines by way of comparison which form of communication is more effective for learning and applying surgical hand disinfection for medical students in their first year of studies: video-based instruction or conventional tuition.

          Methodology: A total of 50 first-year medical students were randomly allocated either to the “Conventional Instruction” (CI) study group or to the “Video-based Instruction” (VI) study group. The conventional instruction was carried out by an experienced nurse preceptor/nurse educator for the operating theatre who taught the preparatory measures and the actual procedure in a two-minute lesson. The second group watched a two-minute video sequence with identical content. Afterwards, both groups demonstrated practically the knowledge they had acquired at an individual practical test station. The quality (a) of the preparation and (b) of the procedure as well as (c) the quality of the results was assessed by 6 blind experts using a check list. The acceptability of the respective teaching method was also asked about using a questionnaire.

          Results: The group performance did not differ either in the preparation ( t=-78, p<0.44) or in the quality ( t=-99, p<0.34). With respect to performance, it was possible to demonstrate a strong treatment effect. In the practical ( t=-3.33, p<0.002, d=0.943) and in the total score ( t=-2.65, p<0.011, d=0.751), the group with video-based instruction achieved a significantly better result. In response to the question as to which of the two learning methods they would prefer, the significant majority (60.4%) of students stated video instruction.

          Conclusion: In this study, the use of the video-based instruction emerged as the more effective teaching method for learning surgical hand disinfection for medical students and is preferable to conventional instruction. The video instruction is associated with a higher learning effectiveness, efficiency and acceptability.

          Zusammenfassung

          Einleitung: Für die Unterrichtsgestaltung zur Einführung der chirurgischen Händedesinfektion stehen unterschiedliche Lernmethoden zur Verfügung. Diese Lernmethoden sollen dabei helfen, das Unterrichtsthema zu strukturieren und zu bewältigen. Der Einsatz eines Videofilms ist, durch die realen Darstellungsmöglichkeiten der praktischen Demonstration, eine Alternative zum konventionellen Unterricht.

          Ziel: Mit der vorliegenden Studie wird vergleichend untersucht, welche Vermittlungsform effektiver für das Erlernen und Anwenden der chirurgischen Händedesinfektion von Medizinstudenten im 1. Studienjahr ist: videobasierte Instruktion oder konventioneller Unterricht.

          Methodik: Insgesamt wurden 50 Medizinstudierende im 1. Studienjahr per Zufall entweder der Lerngruppe „konventionelle Instruktion“ (KI) oder der Lerngruppe „videobasierte Instruktion“ (VI) zugeordnet. Die konventionelle Instruktion erfolgte durch einen erfahrenen Nurse Preceptors/Nurse Educators für den Operationssaal, der die vorzubereitenden Massnahmen sowie die eigentliche Prozedur im Rahmen einer zweiminütigen Lektion vermittelte. Die zweite Gruppe sah eine Videosequenz von 2 Minuten mit identischen Inhalten. Beide Gruppen demonstrierten ihr akkumuliertes Wissen im Anschluss praktisch an einer einzelnen praktischen Prüfungsstation. Die Güte (a) der Vorbereitung und (b) der Prozedur wurde ebenso wie (c) die Qualität des Ergebnisses von 6 geblendeten Experten anhand einer Checkliste beurteilt. Die Akzeptanz der jeweiligen Vermittlungsform wurde mittels eines Fragebogens erfragt.

          Ergebnisse: Die Gruppenleistungen unterschieden sich weder in der Vorbereitung ( t=-78, p<0.44) noch in der Qualität ( t=-99, p<0.34). In Hinblick auf die Performanz konnte ein starker Treatment-Effekt nachgewiesen werden. In der Durchführung ( t=-3.33, p<0.002, d=0.943) sowie im Total Score ( t=-2.65, p<0.011, d=0.751) erzielte die Gruppe mit videobasierter Instruktion ein signifikant besseres Ergebnis. Auf die Frage, welche der beiden Lernmethoden sie bevorzugen würden, wurde von den Studenten mit deutlicher Mehrheit (60.4%) die Videoinstruktion angegeben.

          Schlussfolgerung: Der Einsatz der videobasierten Instruktion stellte sich in dieser Studie als die effektivere Vermittlungsform zum Erlernen der chirurgischen Händedesinfektion für Medizinstudierende heraus und ist der konventionellen Instruktion vorzuziehen. Die Videoinstruktion ist mit höherer Lerneffektivität, Effizienz und Akzeptanz assoziiert.

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          Most cited references 16

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          Teaching suturing and knot-tying skills to medical students: a randomized controlled study comparing computer-based video instruction and (concurrent and summary) expert feedback.

          We carried out a prospective, randomized, 4-arm study including control arm, blinding of examiners to determine effectiveness of computer-based video instruction (CBVI) and different types of expert feedback (concurrent and summary) on learning of a basic technical skill. Using bench models, participants were pre-tested on a suturing and instrument knot-tying skill after viewing an instructional video. The students were subsequently assigned randomly to 4 practice conditions: no additional intervention (control), self study with CBVI, expert feedback during practice trials (concurrent feedback), and expert feedback after practice trials (summary feedback). All participants underwent 19 trials of practice, over 1 hour, in their assigned training condition. The effectiveness of training was assessed both at an immediate post-test and 1 month later at a retention test. Performance was evaluated using both expert-based (Global Rating Scores) and computer-based assessment (Hand Motion Analysis). Data were analyzed using repeated-measures ANOVA. There were no differences in GRS between groups at pre-test. The CBVI, concurrent feedback and summary feedback methods were equally effective initially for the instruction of this basic technical skill to naive medical students and displayed better performance than control (control, 12.71 [10.79 to 14.62]; CBVI, 16.39 [14.38 to 18.40]; concurrent, 16.97 [15.79 to 18.15]; summary, 16.09 [13.57 to 18.62]; P .05). Our study showed that CBVI can be as effective as summary expert feedback in the instruction of basic technical skills to medical students. Thoughtfully incorporated into technical curricula, CBVI can make efficient use of faculty time and serve as a useful pedagogic adjunct for basic skills training. Additionally, our study provides evidence supporting an increased role of summary feedback to effectively train novices in technical skills.
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            Comparison of expert instruction and computer-based video training in teaching fundamental surgical skills to medical students.

            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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              Use of online clinical videos for clinical skills training for medical students: benefits and challenges

              Background Multimedia learning has been shown effective in clinical skills training. Yet, use of technology presents both opportunities and challenges to learners. The present study investigated student use and perceptions of online clinical videos for learning clinical skills and in preparing for OSCE (Objective Structured Clinical Examination). This study aims to inform us how to make more effective us of these resources. Methods A mixed-methods study was conducted for this study. A 30-items questionnaire was administered to investigate student use and perceptions of OSCE videos. Year 3 and 4 students from 34 Korean medical schools who had access to OSCE videos participated in the online survey. Additionally, a semi-structured interview of a group of Year 3 medical students was conducted for an in-depth understanding of student experience with OSCE videos. Results 411 students from 31 medical schools returned the questionnaires; a majority of them found OSCE videos effective for their learning of clinical skills and in preparing for OSCE. The number of OSCE videos that the students viewed was moderately associated with their self-efficacy and preparedness for OSCE (p < 0.05). One-thirds of those surveyed accessed the video clips using mobile devices; they agreed more with the statement that it was convenient to access the video clips than their peers who accessed the videos using computers (p < 0.05). Still, students reported lack of integration into the curriculum and lack of interaction as barriers to more effective use of OSCE videos. Conclusions The present study confirms the overall positive impact of OSCE videos on student learning of clinical skills. Having faculty integrate these learning resources into their teaching, integrating interactive tools into this e-learning environment to foster interactions, and using mobile devices for convenient access are recommended to help students make more effective use of these resources.
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                Author and article information

                Affiliations
                [1 ]Bern, Schweiz
                [2 ]Inselspital Bern, Universitätsklinik für Plastische- und Handchirurgie, Bern, Schweiz
                [3 ]Universität Bern, Institut für Medizinische Lehre Abteilung für Unterricht und Medien, Bern, Schweiz
                Author notes
                *To whom correspondence should be addressed: Uwe Weber, Spitalackerstrasse 64, CH-3013 Bern, Schweiz, E-mail: uweweber@ 123456hotmail.com
                Journal
                GMS J Med Educ
                GMS J Med Educ
                GMS J Med Educ
                GMS Journal for Medical Education
                German Medical Science GMS Publishing House
                2366-5017
                15 August 2016
                2016
                : 33
                : 4 , Clinical skills
                zma001056 Doc57 urn:nbn:de:0183-zma0010569
                10.3205/zma001056
                5003145
                Copyright © 2016 Weber et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.

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