Using Instructional Design Principles in Developing Skill Acquisition Workshops in Hand Surgery-Our Experience

Abstract

Hand surgery is very much a psychomotor dominant specialty requiring the need for predictable, reliable and cost effective means of transferring and developing surgical skills. The need for a high quality simulations model to acquire skills is important in skill training. In this paper we identified real world problems of skill gaps in hand surgery and used the theories of instructional design (ID) to analyse the instructional needs in the problems and then generated solutions using the principles of ID. Based on the individual needs of the learners and entry behavior and characteristics, the framework developed instructional activities and materials and used the concept of the flipped classroom, allowing for effective and efficient transfer of information and skills allowing for adequate feedback and assessment to achieve the stated objectives of the instructions. It included generation of appropriate tools to evaluate the effectiveness of the whole ID framework. Trainees may be trusted to perform a professional task with sufficient independence. This professional activity that is required in the community is called a Entrustable Professional Activities (EPAs). EPAs are entrusted when a supervisor is confident the trainee can demonstrate the knowledge, skills and attitude required of the task, knows when to ask for additional help and can be trusted to seek assistance in a timely manner. The authors developed the EPA for trainees in hand surgery care based on prior unpublished research. 4 skill acquisition workshops were conceptualized and developed based on the ADDIE (Analyse, Design, Develop, Implement, and Evaluate) framework of Instructional Design. The 4 workshops were: Injured Hand Assessment; Flexor Tendon Workshop; Hand Fracture Fixation; Micro-neural repair workshop. The ADDIE and Gagnes 9 events of instruction framework was used to analyse the instructional goals and needs and formulated strategies to bridge the gap by developing the instructional events for delivery of the learning in the form of an intensive course to transfer knowledge and skills using a high fidelity simulated models. Using Gagnes 9 events of instruction, the curriculum, pedagogy, and assessment were developed and the resource materials were posted on an open online learning management system. (www.handsurgeryedu.com). This formed the basis of the flipped workshop to maximizing resources during the face to face skill acquisition workshops. This paper shows that the use of the Instructional Design models like ADDIE and Gagne’s nine events and the use of open educational resources hosted on an open learning management system is a useful strategy in designing surgical skill workshops and is a reliable and predictable tool in producing learning programs for surgeons in a cost effective manner.