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.