Deconstructing forearm casting task by videos with step-by-step simulation teaching improved performance of medical students: is making working student's memory work better similar to a process of artificial intelligence or just an improvement of the prefrontal cortex homunculus?

Abstract

To compare two teaching methods of a forearm cast in medical students through simulation, the traditional method (Trad) based on a continuous demonstration of the procedure and the task deconstruction method (Decon) with the procedure fragmenting into its constituent parts using videos. During simulation training of the below elbow casting technique, 64 medical students were randomized in two groups. Trad group demonstrated the entire procedure without pausing. Decon group received step-wise teaching with educational videos emphasizing key components of the procedure. Direct and video evaluations were performed immediately after training (day 0) and at sixmonths. Performance in casting was assessed using a 25-item checklist, a sevenitem global rating scale (GRS Performance), and a oneitem GRS (GRS Final Product). Fifty-two students (Trad n = 24; Decon n = 28) underwent both day zero and sixmonth assessments. At day zero, the Decon group showed higher performance via video evaluation for OSATS (p = 0.035); GRS performance (p < 0.001); GRS final product (p < 0.001), and for GRS performance (p < 0.001) and GRS final product (p = 0.011) via direct evaluation. After sixmonths, performance was decreased in both groups with ultimately no difference in performance between groups via both direct and video evaluation. Having done a rotation in orthopaedic surgery was the only independent factor associated to higher performance. The modified video-based version simulation led to a higher performance than the traditional method immediately after the course and could be the preferred method for teaching complex skills.