Acquisition of surgical skills: A randomized trial of didactic, videotape, and computer-based training

Abstract

Background: Although computer-based training (CBT) can enhance didactic instruction, few studies have assessed the efficacy of CBT for basic surgical skills training. This study compares CBT with traditional methods of basic surgical skills training. Methods: Sixty-nine naive medical students were randomized into 3 treatment groups for basic surgical skills instruction: didactic, videotape, or CBT. All instructional material contained the same pictures, text, and audio. With use of a multiple-choice question examination and a series of performance stations, students were objectively assessed before, immediately after, and 1 month after skills instruction. Raters were blinded to treatment modality during the follow-up evaluation. Results: There were no significant differences among the groups before treatment. After treatment, the didactic group scored higher on the multiple-choice question examination. In contrast, the videotape and CBT groups demonstrated statistically significant ( P < .01) enhancement of technical skills compared with the didactic group. After 1 month, a calculated performance quotient revealed statistically significant ( P < .01) improvement only in the CBT group. The amount of time students spent practicing their skills was not significantly different among the groups. Conclusions: CBT is as effective as, and possibly more efficient, than traditional methods of basic surgical skills training for medical students. (Surgery 1999;126:330-6.)