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Individualised Expert Feedback is Not Essential for Improving Basic Clinical Skills Performance in Novice Learners: A Randomized Trial

Lookup NU author(s): Professor Alexander PhillipsORCiD, Dr Jo Matthan, Dr Lucy Bookless, Dr Anantha Madhavan, Dr Anna Porter, Dr Craig Nesbitt, Professor Gerard Stansby


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© 2016 Association of Program Directors in Surgery. Objective: To determine whether unsupervised video feedback (UVF) is as effective as direct expert feedback (DEF) in improving clinical skills performance for medical students learning basic surgical skills-intravenous cannulation, catheterization, and suturing. Background: Feedback is a vital component of the learning process, yet great variation persists in its quality, quantity, and methods of delivery. The use of video technology to assist in the provision of feedback has been adopted increasingly. Methods: A prospective, blinded randomized trial comparing DEF, an expert reviewing students' performances with subsequent improvement suggestions, and UVF, students reviewing their own performance with an expert teaching video, was carried out. Medical students received an initial teaching lecture on intravenous cannulation, catheterization, and suturing and were then recorded performing the task. They subsequently received either DEF or UVF before reperforming the task. Students' recordings were additionally scored by 2 blinded experts using a validated proforma. Results: A total of 71 medical students were recruited. Cannulation scores improved 4.3% with DEF and 9.5% with UVF (p = 0.044), catheterization scores improved 8.7% with DEF and 8.9% with UVF (p = 0.96), and suturing improved 15.6% with DEF and 13.2% with UVF (p = 0.54). Improvement from baseline scores was significant in all cases (p < 0.05). Conclusion: Video-assisted feedback allows a significant improvement in clinical skills for novices. No significant additional benefit was demonstrated from DEF, and a similar improvement can be obtained using a generic expert video and allowing students to review their own performance. This could have significant implications for the design and delivery of such training.

Publication metadata

Author(s): Phillips AW, Matthan J, Bookless LR, Whitehead IJ, Madhavan A, Rodham P, Porter ALR, Nesbitt CI, Stansby G

Publication type: Article

Publication status: Published

Journal: Journal of Surgical Education

Year: 2017

Volume: 74

Issue: 4

Pages: 612-620

Print publication date: 01/07/2017

Online publication date: 29/12/2016

Acceptance date: 02/04/2016

ISSN (print): 1931-7204

ISSN (electronic): 1878-7452

Publisher: Elsevier Inc.


DOI: 10.1016/j.jsurg.2016.12.003


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