CD-ROM versus standard text-based model for gynecologic operative procedures: a randomized controlled trial

Abstract

Objective: To compare CD-ROM use with the standard text-based model ( TeLinde’s) in the teaching of common gynecologic operative procedures to residents in the field of obstetrics and gynecology. Methods: In a randomized controlled trial, first-, second- and third-year residents in an obstetrics and gynecology department were randomized to receive either a CD-ROM that contains digitally edited surgical photographs with surgical text or a copy of the chapter of TeLinde’s that correlates with the operative procedure performed. The resident either viewed the CD-ROM or read the text model the evening before the surgery and then filled out a questionnaire afterward. Operations included TAH/BSO, TVH/BSO, cold knife conization, anterior colporrhaphy, perineorrhaphy, and Burch retropubic urethropexy. Helpfulness with indications, pelvic anatomy, understanding of techniques/methods, learning the names and uses of surgical instruments, and completing dictation were assessed in a rating system of 0 (not helpful) to 7 (extremely helpful). Results: During the study period, six residents completed questionnaires in both groups (CD-ROM, text group). The mean differences in resident evaluation of the surgical indications were 2.67 (Mann-Whitney rank sum, P = 0.0022); pelvic anatomy, 3.0 (Mann-Whitney rank sum, P = 0.0065); surgical techniques, 1.83 (Mann-Whitney rank sum, P = 0.0082); knowledge and use of instruments, 3.0 (Mann-Whitney rank sum, P = 0.0022); aid in completing surgical dictations, 3.167 (Mann-Whitney rank sum, P = 0.0022); and overall usefulness: 2.33 (Mann-Whitney rank sum, P = 0.0022). Conclusion: One of the biggest complaints from junior residents has been the lack of good photographs in traditional surgical textbooks. The residents in this study felt that the photographs shown on the CD-ROM better aided their knowledge of the indications, techniques, and surgical anatomy of the aforementioned procedures. We believe that the CD-ROM medium is underused and that it could provide better resident education, especially if combined with the traditional surgical textbook.