Comparison of textbook versus three-dimensional animation versus cadaveric training videos in teaching laparoscopic rectal surgery: a prospective randomized trial.

Abstract

The aim of this prospective randomized study was to compare the effectiveness of various educational tools in laparoscopic rectal surgery, including surgical textbooks, animation and cadaveric videos. Initially, an electronic assessment test assessing knowledge of laparoscopic rectal surgery was created and validated. The test was sent to graduates completing a general surgery residency programme in Turkey, who were then randomized into four groups based on the type of study material. After a 4week study period, the volunteers were asked to answer the same electronic assessment test imported into an edited live laparoscopic rectal surgery video. Pre- and posteducation assessment tests among the groups were compared. A total of 168 volunteers completed the pre-education assessment test and were randomized into four groups. Pre-education assessment test scores were similar among the groups (p>0.05). Of 168 volunteers, 130 (77.3%) completed the posteducation assessment test. Posteducation assessment test scores were significantly higher in the three-dimensional (3D) animation+cadaveric video group (p<0.01), the 3D animation group (p<0.01) and the cadaveric group (p<0.01) compared with the textbook group. Moreover, posteducation assessment test scores were significantly higher in the 3D animation+cadaveric video group than the 3D animation group (p<0.01). Each group's posteducation assessment test scores were significantly higher than the pre-education assessment test scores, with the exception of the textbook group. Our study demonstrates that 3D animation+cadaveric videos, 3D animation alone and cadaveric videos are all superior to a surgical textbook when teaching laparoscopic rectal cancer surgery. Finally, our results show that 3D animation and cadaveric videos are also superior to textbooks in enabling an understanding of rectal surgery.