Video-Based Guided Simulation without Peer or Expert Feedback is Not Enough: A Randomized Controlled Trial of Simulation-Based Training for Medical Students

• Published in: World journal of surgery Vol. 45; no. 1; pp. 57 - 65
• Main Authors: Tejos, Rodrigo, Crovari, Fernando, Achurra, Pablo, Avila, Ruben, Inzunza, Martín, Jarry, Cristian, Martinez, Jorge, Riquelme, Arnoldo, Alseidi, Adnan, Varas, Julian
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 2021; Springer Nature B.V
• Subjects: Abdominal Surgery; Cardiac Surgery; Clinical trials; Feedback; General Surgery; Learning; Medical students; Medicine; Medicine & Public Health; Original Scientific Report; Simulation; Skills; Stitches; Students; Surgery; Sutures; Thoracic Surgery; Training; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-020-05766-x

Background
Feedback is a pivotal cornerstone and a challenge in psychomotor training. There are different teaching methodologies; however, some may be less effective.
Methods
A prospective randomized controlled trial was conducted in 130 medical students to compare the effectiveness of the video-guided learning (VLG), peer-feedback (PFG) and the expert feedback (EFG) for teaching suturing skills. The program lasted 4 weeks. Students were recorded making 3-simple stitches (pre-assessment and post-assessment). The primary outcome was a global scale (OSATS). The secondary outcomes were performance time, specific rating scale (SRS) and the impact of the intervention (IOI), defined as the variation between the final and initial OSATS and SRS scores.
Results
No significant differences were found between PFG and EFG in post-assessment results of OSATS, SRS scores or in the IOI for OSATS and SRS scores. Post-assessment results of PFG and EFG were significantly superior to VLG in OSATS and SRS scores [(19.8 (18.5–21); 16.6 (15.5–17.5)) and (20.3 (19.88–21); 16.8 (16–17.5)) vs (15.7 (15–16); 13.3 (12.5–14)) (
p
 < 0.05)], respectively. The results of PFG and EFG were significantly superior to VLG in the IOI for OSATS [7 (4.5–9) and 7.4 (4.88–10) vs 3.5 (1.5–6) (
p
 < 0.05)] and SRS scores [5.4 (3.5–7) and 6.3 (4–8.5) vs 3.1 (1.13–4.88) (
p
 < 0.05)], respectively.
Conclusion
The video-guided learning methodology without any kind of feedback is not enough for teaching suturing skills compared to expert or peer feedback. The peer feedback methodology appears to be a viable alternative to handling the emerging demands in medical education.