Effectiveness of an instructional DVD on third- and fourth-degree laceration repair for obstetrics and gynecology postgraduate trainees

Abstract

Objective To assess the effectiveness of an instructional DVD on the anatomy and repair of anal sphincter lacerations to improve postgraduate trainees’ understanding. Methods A total of 71 obstetrics and gynecology trainees completed a pretest of third- and fourth-degree lacerations to assess baseline knowledge and perceptions. Question categories included anatomy, antibiotics, anesthesia, repair methods, complications, postoperative care, and risk factors. After 1 year of clinical experience, 67 trainees (94%) were randomly assigned into DVD (intervention) and non-DVD (control) groups. A post-test was administered 4 weeks later. Results In the DVD group (n = 34), mean scores on the pretest versus the post-test were 65% vs 74% for postgraduate year (PGY)-1 ( P = 0.09); 72% vs 83% for PGY-2 ( P = 0.06); 67% vs 83% for PGY-3 ( P = 0.01); and 75% vs 87% for PGY-4 ( P < 0.001). In the non-DVD group (n = 33), mean scores did not change significantly for any year level. The increase in score from pretest to post-test was significantly different between the 2 groups, independent of year ( P < 0.001). DVD group scores improved significantly over non-DVD group scores in anatomy ( P = 0.005) and repair methods ( P = 0.042) subscales. Conclusion An educational video is an effective tool for improving understanding of third- and fourth-degree lacerations for physicians-in-training.