A supplemental video teaching tool enhances splinting skills

Does a Video-Based and 3D Animation Hybrid Learning System Improve Teaching Outcomes in Orthopedic Surgery? A Randomized Controlled Trial

OBJECTIVE

This study aims to evaluate the instructional efficacy of a 3D Surgical Training System (3DSTS), which combines real surgical footage with high-definition 3D animations, against conventional surgical videos and textbooks in the context of orthopedic proximal humerus fracture surgeries.

DESIGN

Before the experiment, 89 participants completed a pre-educational knowledge assessment. They were then randomized into 3 groups: the 3DSTS group (n = 30), the surgical video (SV) group (n = 29), and the textbook group (n = 30). After their respective teaching courses, all participants took a posteducational assessment and completed a perceived cognitive load test. The 3DSTS group also filled out a satisfaction survey. Once all assessments were finished, the SV and textbook groups were introduced to the 3DSTS course and subsequently completed a satisfaction survey. All statistical analyses were executed using IBM SPSS version 24 (IBM Corp., Armonk, NY). For data fitting normal distribution, we employed one-way analysis of variance (one-way ANOVA) and Tukey HSD tests, whereas, for non-normally distributed data, we used Kruskal-Wallis H tests and Dunn's tests. The significance level for all tests was set at p < 0.05.

SETTING

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, P. R. China.

PARTICIPANTS

About 89 doctors who undergoing standardized residents training.

RESULT

The initial assessment scores among the three groups were comparable, showing no significant statistical difference. Post-education revealed a marked difference in the scores, with the 3DSTS group outperforming both the SV and textbook groups. Specifically, the 3DSTS group exhibited statistically greater improvement in areas such as procedural steps, and specialized surgical techniques compared to the SV and textbook groups. During the 3DSTS teaching process, participants reported the least perceived cognitive load and expressed strong satisfaction, highlighting that the instructional materials are well-prepared, and considering this teaching method superior and more innovative than previous courses they had encountered.

CONCLUSION

The 3D Surgical Training System, integrating real videos with 3D animations, significantly enhances orthopedic surgery education over conventional methods, providing improved comprehension, lower cognitive load, and standardized learning outcomes. Its efficacy and high participant satisfaction underscore its potential for broader adoption in surgical disciplines. This study is registered with ClinicalTrials. gov ID: ChiCTR2300074730.

A History of Musculoskeletal Medicine and Its Place and Progress in Undergraduate Medical Education

Musculoskeletal diseases are responsible for some of the most prevalent conditions affecting population health in the world. Despite the prevalence of these conditions, musculoskeletal medicine has a fraught history within the world of undergraduate medical education. We review the origins of musculoskeletal medicine, its evolution in undergraduate medical education, and progress that has been made over the last decade as a result of global initiatives such as the Bone and Joint Decade. Understanding the history of musculoskeletal medicine is essential to contextualizing the problems that exist today and creating comprehensive solutions to fill the gaps that persist in musculoskeletal curricula.

A Video Teaching Tool Is Effective for Training Residents in Hip Arthroplasty Templating

Work hour restrictions imposed on orthopedic surgery residents since the early 2000s have reduced educational opportunities at the workplace and encouraged alternative strategies for teaching outside the clinical setting. Preoperative templating is essential for safe and effective total hip arthroplasty (THA) and is accurate in predicting final implants. We sought to determine the effectiveness of a video tool for teaching orthopedic residents basic THA templating skills. We developed a video-based teaching tool with instructions on proper THA templating techniques. Ten cases were selected for testing, after excluding patients with severe hip deformities and poor-quality radiographs and only retaining those with concordance between templating by the senior authors and implanted components. The study subjects included three postgraduate year 1 (PGY-1), three PGY-2, and three PGY-5 residents, and three adult reconstruction fellows (PGY-6). Templating skills were assessed before and after watching the instructional video. The evaluation included the size and positioning of femoral and acetabular components, as well as the restoration of leg length. Each templating session was repeated twice. Variance was measured to evaluate consistency in measurements. A linear mixed model and F-test were used for statistical analyses. The number of years in training significantly affected performance prior to exposure to the instructional video. Post-exposure, there was a significant improvement in the accuracy of sizing and positioning of acetabular and femoral components for PGY-1, PGY-2, and PGY-5 residents. The results achieved were comparable to PGY-6 examiners, who did not gain substantial performance benefits from the instructional video. Limb length restoration was less affected by experience or exposure to the video. Component positioning and sizing, as well as leg length discrepancy (LLD), showed a significant decrease in variance after the intervention in all study groups. Video learning is reliable in teaching invaluable skills to orthopedic surgery residents without encroaching on work hours. We conceived a concise video to train orthopedic residents to perform THA templating with proper technique and demonstrated its efficiency and reproducibility.

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?

PURPOSE

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.

METHODS

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 six months. Performance in casting was assessed using a 25-item checklist, a seven item global rating scale (GRS Performance), and a one item GRS (GRS Final Product).

RESULTS

Fifty-two students (Trad n = 24; Decon n = 28) underwent both day zero and six month 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 six months, 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.

CONCLUSIONS

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.

Advances in e-learning in undergraduate clinical medicine: a systematic review

BACKGROUND

E-learning is recognised as a useful educational tool and is becoming more common in undergraduate medical education. This review aims to examine the scope and impact of e-learning interventions on medical student learning in clinical medicine, in order to aid medical educators when implementing e-learning strategies in programme curricula.

METHODS

A systematic review compliant with PRISMA guidelines that appraises study design, setting and population, context and type of evaluations. Specific search terms were used to locate articles across nine databases: MEDLINE/PubMed, ScienceDirect, EMBASE, Cochrane Library, ERIC, Academic Search Complete, CINAHL, Scopus and Google Scholar. Only studies evaluating e-learning interventions in undergraduate clinical medical education between January 1990 and August 2021 were selected. Of the 4,829 papers identified by the search, 42 studies met the inclusion criteria.

RESULTS

The 42 studies included varied in scope, cognitive domain, subject matter, design, quality and evaluation. The most popular approaches involved multimedia platforms (33%) and case-based approaches (26%), were interactive (83%), asynchronous (71%) and accessible from home (83%). Twelve studies (29%) evaluated usability, all of which reported positive feedback. Competence in use of technology, high motivation and an open attitude were key characteristics of successful students and preceptors.

CONCLUSIONS

Medical education is evolving consistently to accommodate rapid changes in therapies and procedures. In today's technologically adept world, e-learning is an effective and convenient pedagogical approach for the teaching of undergraduate clinical medicine.

Effectiveness of Supplementary Materials in Teaching the Veterinary Neurologic Examination

Clinical neurology can be difficult for veterinary students to comprehend, and part of understanding the clinical aspect is performing a proper neurologic examination. In this study, first-year veterinary students in a Small Animal Physical Exam and Anatomy rotation were given supplemental learning activities to determine their effect on student procedural knowledge and motivation in performing a neurologic examination. Students were randomly assigned to one of three groups: the first watched a video of a clinician performing the neurologic examination, the second read a handout about the neurologic exam, and the third was the control group, where students were not provided any supplemental activities. At the start and end of the rotation, students participated in a survey assessing their overall procedural knowledge and motivation to learn about the neurologic exam. No notable improvement occurred in overall student knowledge from the beginning to end of the rotation, nor when using supplemental material (p > .05). However, there was a significant difference in quiz scores between the three condition groups (p < .01), suggesting the type of learning activity did influence student learning. Additionally, students in the video and reading groups showed a significant increase in motivational scores compared with those in the control group (p < .05), demonstrating supplemental learning activities do improve student motivation in learning about the neurologic examination. This study provides evidence that while supplemental materials may not immediately help veterinary students learn to perform the neurologic examination, they do have a positive impact on students' learning motivation.

Virtual Trauma Meeting as a Component of Undergraduate Orthopaedic Education

Introduction: Virtual teaching has proven effective for medical students during the COVID-19 pandemic. This study is the first to describe an undergraduate orthopaedic teaching strategy in the format of virtual trauma meetings (VTM).

Methods: Clinical medical students from the Universities of Bristol and Cardiff were invited to attend five VTM between October and November 2020. These were delivered by consultants and speciality doctors via Zoom software. An 11-item feedback form was distributed after each session to assess the relevance of teaching material, student confidence in asking and answering questions, and if students would benefit from further sessions. Several open-ended questions were designed to evaluate aspects of the session that were most useful, which orthopaedic topics were of high priority and if they had any suggestions for improvement. Our initial aim was to assess student acceptance of the virtual format. Several months later pre-recorded material was uploaded onto YouTube and post hoc questionnaires were analysed.

Results: A total of 50 students attended, with a median of 11±6 attending per session, producing a total of 26 feedback responses. Among the responders, there were 10 males and nine females and 63% of the students were in their third year. 100% of students felt comfortable asking questions and 96% felt comfortable answering questions. X-ray interpretation and management of fractures were the highest priority subjects. The majority of students considered the interaction between senior and junior doctors most valuable, and the most common improvement suggested was the inclusion of polls or OSCE-styled questions.

Conclusions: VTM could be a useful resource to enhance undergraduate trauma and orthopaedic (T&O) education by providing student-focused material in an open learning environment.

Undergraduate Medical Students' Perceptions of an Online Audio-Visual-Based Module for Teaching Musculoskeletal Physical Examination Skills

INTRODUCTION

Video-based learning has gained prominence in medical education and, more recently, in musculoskeletal teaching. This study investigated medical students' perceptions of the effectiveness of online video-based learning for musculoskeletal physical examination skills.

METHODS

For one academic year, undergraduate medical students were instructed online through video-based learning before bedside teaching about the physical examination of knee and shoulder joints. At the end of the course, the students participated in a survey to assess their perceptions of the online video-based learning module using a pre-validated questionnaire. The questionnaire consisted of closed-ended and open-ended questions. The closed-ended question responses were assessed using a Likert scale; the open-ended responses were analyzed qualitatively.

RESULTS

In total, 242 out of 310 students who participated in the online video-based learning responded to the survey. Most students found the teaching approach to be satisfactory and preferable to traditional teaching methods. However, they also felt that these modules could not replace hands-on practice. The most helpful aspects of the training modules were a better understanding of the specific tests, technique, and sequence of administering the physical examination. Perceived limitations included the inadequately addressed theoretical basis of the physical examination and the special tests, the need for more time to explain clinical anatomy, and the practical implications of the positive special tests.

CONCLUSION

Undergraduate medical students perceive VBL as helpful for MPES learning. The positive aspects of the VBL approach in teaching MPES are that it is comprehensive, easily accessible, offers standardized teaching, save times, and it includes demonstrations of special tests, examination techniques, and the sequence and organization of the clinical examination. The main perceived limitations were lack of content regarding clinical reasoning and the anatomical basis of the clinical tests.

Learner Preferences and Perceptions of Virtual Hand Surgery Education During the COVID-19 Pandemic

PURPOSE

In response to the COVID-19 pandemic, many postgraduate medical education lectures and conferences have been moved to a virtual platform. Questions remain regarding the effectiveness of virtual education, what types of educational offerings can be transitioned to a virtual format, and what types of curricula should still take place in person.

METHODS

This study surveyed trainees from the United States who participated in a single institution's hand surgery virtual flipped classroom curriculum of 6 week-long modules. Demographics, premodule and postmodule achieved levels of learning based on Bloom's taxonomy, technology usage, and preferences were surveyed.

RESULTS

Of the 65 participants, 41 (63.1%) responded to the survey. Trainees included hand surgery fellows (27/41 [65.9%]), orthopedic surgery residents (11/41[26.8%]), and plastic surgery residents (3/41 [7.3%]). On average, most trainees read, viewed, and participated in more than half of the articles (28/41 [68.3%]), electronic videos (31/41 [75.6%]), and conferences (35/41 [85.4%]) per week. The median level of achieved learning increased from "I can apply" to "I can analyze" for all modules. Self-directed learning was preferred for basic facts and knowledge (26/41 [63.4%]) and faculty-directed learning was preferred to review and practice advanced concepts (34/41 [82.9%]). The participants perceived benefits of the virtual curriculum to include increased scheduling flexibility (8/41[19.5%]), expert opinions (7/41 [17.1%]), and diversity of educational formats (3/41 [7.3%]). The perceived drawbacks included decreased interaction (8/41 [19.5%]), technical difficulties (6/41 [14.6%]), excessive detail (3/41 [7.3%]), and single-institution bias (2/41 [4.9%]).

CONCLUSIONS

The flipped virtual classroom model is an effective and preferred method of instruction for trainees. Trainees achieved a higher level of learning following the completion of each week-long module. Considerations for the implementation of a virtual curriculum include content quality, quantity, and reducing single-institution bias.

CLINICAL RELEVANCE

The implementation of virtual learning can enhance hand surgery education for the modern learner.

Social Media and Its Use in Orthopaedic Surgery Resident Education and Training

»

The use of social media by health-care professionals and medical educators has been increasing over the past decade.

»

Online social networks, professional networks, blogs, microblogs, forums, podcasts, and video-sharing platforms can be used effectively to communicate and engage with, as well as learn from, other residents and attending physicians worldwide.

»

Social media platforms and other web-based applications can serve as powerful educational tools to enhance orthopaedic resident learning, collaboration, teaching, and case discussion.

The future of orthopaedic surgical education: Where do we go now?

INTRODUCTION

COVID-19 will undoubtedly change the future landscape of medical and surgical education. The economic and environmental advantages of virtual learning are clear, while access to a wider range of resources and subject specialists makes the adoption of virtual learning within surgical education an attractive prospect.

AIMS

This literature review aims to evaluate evidence on the effectiveness of virtual education in orthopaedics and how we might implement positive changes to educational practice in the future, as a result of lessons learned during the COVID-19 pandemic.

METHODOLOGY

We performed a review of the literature reporting on efficacy of learning outcomes achieved as a result of virtual education within orthopaedic surgery. Electronic searches were performed using NICE healthcare databases from the date of inception to March 2021. Relevant studies were identified, data extracted, and qualitative synthesis performed.

RESULTS

14 manuscripts with a total of 1548 participants (orthopaedic trainees or medical students) were included for analysis. Nine studies (n = 1109) selected compared e-learning to conventional learning material (control group). All nine studies reported significantly higher outcome scores for e-learning participants compared to control participants (p < 0.001 to p < 0.05). The remaining studies compared blended e-learning approaches or evaluated pre/post intervention improvements in learning outcomes. All studies demonstrated a significant improvement in learning outcomes (p < 0.0001 to p < 0.01). The majority of studies (64%) used a blended approach. No studies were identified reporting efficacy of webinars or videoconferencing within orthopaedic education.

CONCLUSION

A blended approach, combining virtual teaching, face-to-face instruction and distance learning tools, based on the evidence we have provided, would improve the quality of knowledge reception and retention, and learner satisfaction. However, in order to be successful, it is vital that these educational programmes are designed with the needs of the learner in mind, and an awareness of best practice for virtual teaching and learning.

The Development of an Educational Video on Blood Pressure Measurement for Pharmacy Students

INTRODUCTION

High blood pressure is an important worldwide health issue. Pharmacists can perform multifaceted tasks in hypertension management such as measuring blood pressure. In a time where the use of educational videos in health professions education has increased, an educational video might be an option for teaching blood pressure measurement skills to pharmacy students. This project aimed to develop an educational video tailored to pharmacy students on oscillometric blood pressure measurement in a community pharmacy setting that can be used as a self-instruction video.

METHODS

The video was created with support from the university's multimedia center. The video development was roughly divided into pre-production, production, and post-production. Students' satisfaction with and perception of the video was surveyed.

RESULTS

An 11-minute 33-second self-instruction video in the German language on proper oscillometric blood pressure measurement tailored for pharmacy students was created. Along with descriptive slides, the video delineates the necessary steps of blood pressure measurement in a community pharmacy setting in a role-play, to support students in communication with the patient. Results of a survey on the satisfaction and perception of the video from thirty-seven pharmacy students were included in the analysis and revealed that the video was well accepted by pharmacy students. Moreover, approximately 95% responded that instructional videos should be included in future pharmacy education.

CONCLUSION

We successfully developed an educational video on oscillometric blood pressure measurement for a community pharmacy setting. This work is a valuable form of support for faculty members, who intend to develop educational videos. This might be of interest especially during the coronavirus disease 2019 (COVID-19) pandemic, where distance learning has become highly relevant.

Teaching orthotic design and fabrication content in occupational therapy curricula: Faculty perspectives

STUDY DESIGN

Cross-sectional survey study.

INTRODUCTION

Occupational therapy (OT) programs must provide students with the skills necessary to fabricate orthoses. Input from OT educators can provide valuable insight into how these skills are taught and the resources used.

PURPOSE OF THE STUDY

Explore how instruction in orthotic fabrication is addressed in OT education programs.

METHODS

Surveys were distributed to all accredited OT programs in the United States. Quantitative data were analyzed using descriptive statistics, and content analysis was done on qualitative data to identify themes.

RESULTS

Overall response rate was 25%. Most programs teach orthotic fabrication with demonstration and hands-on laboratory time. Almost half add digital videos in their orthotic course content. The average number of orthoses made ranged from 2 to 5, and the resting hand, wrist, and short opponens immobilization orthoses are the most commonly taught.

DISCUSSION

This study examined the orthotic fabrication curricula in OT programs in the United States, including the time devoted to this topic, types of orthoses covered, course structure and pedagogical strategies used, and whether faculty anticipated changes in their orthotic content. The majority of programs offer this content within other existing courses within the curriculum, including coursework in physical dysfunction, OT interventions, orthopedics, and biomechanics. Only 15% of participants in the current study reported teaching orthotic content as a separate course in their curricula. Interestingly, some participants reported that they plan to offer a full separate orthotics course in their future curricula, whereas others reported combining orthotics content with other coursework or reducing the time spent making custom orthoses in the classroom. It would appear that there is still considerable variability in course structure and content in current OT programs.

CONCLUSION

Participants feel that orthotic fabrication is an essential and integral component of their curricula and that the importance of hands-on learning experiences contributes to students' preparedness and ability to use this knowledge. Student feedback indicated that more time and instruction is desired. Sharing teaching experiences can enhance emerging OT curricula and can impact future practice. Educators must strive to improve and refine curricular content to ensure that graduates have the skills necessary to meet the orthotic needs of their clients.

A scoping review of high-fidelity bench models for teaching closed reduction of distal radial fractures

This article was migrated. The article was marked as recommended.

INTRODUCTION

Simulation training can be beneficial for developing clinical skills without risks to patients. This review considers the literature on simulation models used for teaching closed reduction (manipulation) procedures for distal radius (wrist) fractures, particularly high-fidelity models, and the evidence supporting the use of such models.

METHODS

A scoping review of Medline and Embase was performed.

RESULTS

Five articles described low-fidelity models, predominantly focussing on low costs and teaching basic principles. Three articles and two commentary pieces discussing high-fidelity models were identified.

DISCUSSION

Attitudes towards a high-fidelity simulator were assessed by Egan et al. (2013), who found the majority of participants to be in favour of the model's use as a teaching tool, although participant selection may have been subject to bias. Mayne et al. (2016) subsequently used a high-fidelity model including radio-opaque markers and more objective measurements tools to assess orthopaedic trainees' closed reduction technique and adequacy of the achieved fracture position and casting. Seniority correlated with higher scores on objective structured assessment of technical skills (OSATS) and global rating scores (GRS) but not radiological measures of fracture position or cast quality, and over 90% of all participants achieved an adequate reduction. Seeley et al. (2017) used radiological measurements and time to task completion with another high-fidelity reduction model. The two most experienced participant groups could not be differentiated on any radiological measures of fracture reduction or on the time taken for reduction, although these groups were significantly better than the most junior participants.

CONCLUSION

The discussed models appear helpful to teach inexperienced participants the basic principles and steps in a procedures but a plateau effect appears to limit the potential benefit to more experienced learners. The constraints of educators' time and financial costs may influence the usage of such models in this type of training.

Curriculum Reform and New Technology to Fill the Void of Musculoskeletal Education in Medical School Curriculum

Musculoskeletal (MSK) disease comprises over 20% of all visits to healthcare providers each year, yet a disproportionately small percentage of medical school education focuses on MSK disease. Even among students applying into orthopaedic surgery, less than 50% demonstrate prerequisite anatomic knowledge before beginning their residency. Medical school curriculum reform is needed, given that only 15% have a required MSK curriculum. Inadequate education ultimately leads to poor patient care and forces clinicians to learn MSK medicine later in practice. Although this inadequacy in medical school MSK education has been recognized for decades, little has changed to address this critical deficiency. A successful curriculum development requires defining critical MSK topics, evaluative methods to assess knowledge acquisition, and ultimately assessment of applying that knowledge to the care of patients. Newer strategies for MSK education include "near-peer" learning from senior classmates and residents, clinical immersion within MSK care teams, peer interest groups, and standardize learning platforms and assessment tools. Technologies such as virtual reality simulation, adaptive video learning, and other technologies will inform the development of affordable, succinct, evidence-informed curriculums that can enhance medical student MSK education with universal implementation. As clinical practice evolves to optimize patient care, so should the education of physicians who deliver that care.

The influence of online video learning aids on preparing postgraduate chiropractic students for an objective structured clinical examination

OBJECTIVE

To investigate the influence of providing online procedural videos to postgraduate chiropractic students preparing for an objective structured clinical examination (OSCE).

METHODS

Eighty-three postgraduate chiropractic students enrolled in a diagnostic unit during 2017 received supplemental video resources prior to their final OSCE. Ninety students enrolled in the 2016 offering of the unit acted as the control group. Two-sample t tests were used to compare OSCE results between groups and paired t tests were used for within-group comparisons. Regression analysis was used to examine the association of age, undergraduate grade point average, and gender with the final OSCE scores. Students were also surveyed regarding their perceptions of the video resources using a purpose-built questionnaire.

RESULTS

A paired t test comparing initial and final OSCE scores found a small but significant increase in scores for the 2017 (mean change 3.6 points; p = .001) but not the 2016 (mean change -1.1 scores; p = .09) cohort. The 2017 cohort had significantly more change than the 2016 cohort (mean difference 4.7 points; p < .001). Analysis of responses to the questionnaire highlighted overall positive feedback for the procedural videos.

CONCLUSION

Online procedural videos as learning resources had a small but positive effect on OSCE performance for a group of postgraduate chiropractic students. Students perceived the resource as being helpful for OSCE preparation.

"Virtual" Boot Camp: Orthopaedic Intern Education in the Time of COVID-19 and Beyond

The emergence of COVID-19 as a viral pandemic in early 2020 resulted in notable changes to the daily practice, workflow, and education of orthopaedic residencies internationally. In particular, social distancing, residency restructuring, and redeployment to other services has increased heterogeneity in schedules and made the in-person gathering of trainees for education increasingly challenging. These changes may last until 2024 based on some mathematical models, resulting in notable disruptions to orthopaedic education, especially for junior residents. Therefore, in this study, we describe how we converted our in-person PGY-1 skills course into a "virtual" boot camp based on validated training modules and existing American Board of Orthopaedic Surgeons guidelines. Lessons learned from the experience and potential areas for improvement in the use of newer technology to teach cognitive knowledge and skills modules are highlighted with the hope that this can be useful to other orthopaedic residency programs, during the pandemic and also beyond.

Assessing the Impact of a Training Initiative for Nasopharyngeal and Oropharyngeal Swabbing for COVID-19 Testing

Objective

The accuracy and reliability of COVID-19 testing are critical to limit transmission. After observing variability in testing techniques, we otolaryngologists at a tertiary medical center initiated and evaluated the impact of nasopharyngeal and oropharyngeal swabbing training, including video instruction, to standardize sampling techniques and ensure high-quality specimens.

Methods

Participants in the training were employees (N = 40). Training consisted of an instructional video on how to perform nasopharyngeal and oropharyngeal swabs and a live demonstration. Participants completed pre- and posttraining surveys assessing their knowledge and confidence in performing nasopharyngeal and oropharyngeal swabs. They then performed swabbing on partners, which was graded per a standardized checklist.

Results

Mean scores for knowledge-based questions and confidence in swabbing were significantly higher after the training session (both P < .001). All participants scored ≥6 of 8 on the posttraining checklist. Ninety-five percent rated the video as very or extremely useful.

Discussion

Specialized instruction for nasopharyngeal swabbing improved participants’ knowledge—specifically, the appropriate head position and minimum swab time in nasopharynx—and their confidence. After the training, their swabbing execution scores were high.

Implications for Practice

Video-assisted hands-on instruction for nasopharyngeal swab sampling can be used to standardize teaching. When prompt and accurate testing is paramount, this instruction can optimize procedural technique and should be used early and often. In addition, there may be a professional responsibility of otolaryngologists to participate in such initiatives.

Video education to improve clinical skills in the prevention of and response to vasovagal syncopal episodes

Background

Objective

Methods

Results

Conclusion

Role of "Video Assisted Lecture" on Changing Albanian Undergraduate Students' Opinion Regarding Pain-free Dental Injections in Children

AIM

To evaluate the effectiveness of video assisted lecture in changing the opinions of dental students toward pain-free dental injections in children.

METHODS

The fifth-year students (n:62) of University of Medicine of Tirana, Faculty of Dental Medicine participated in the study. The study was conducted in two stages: first a Theoretical lecture (Stage 1), "Pain-free Local Analgesia Techniques in Children" was provided, and was followed by a second lecture supported by video recordings of real clinical cases (Stage 2). Students' opinions were evaluated by means of a short survey administered before the lectures, after the theoretical lecture, and after the video assisted lecture.

RESULTS

Before the study, only 47.9% of students believed in the possibility (agree and definitely agree) of pain-free local anesthesia in children, whereas after the study, the percentage had risen to 67.7% (p=0.0001). Baseline opinions of students changed significantly after the video-assisted lecture (p=0.0001). However, there is no statistical difference between mean scores of theoretical lecture (Stage 1) and video-assisted lecture (Stage 2).

CONCLUSIONS

Theoretical lecture (Stage 1) was found to be significantly effective in changing the opinions regarding "Pain-free dental injections in children," however, a video based dental education (Stage 2) was found to be relatively effective in supporting the change in dental students' opinion.

Application of flipped classroom pedagogy to the human gross anatomy laboratory: Student preferences and learning outcomes

To improve student preparedness for anatomy laboratory dissection, the dental gross anatomy laboratory was transformed using flipped classroom pedagogy. Instead of spending class time explaining the procedures and anatomical structures for each laboratory, students were provided online materials to prepare for laboratory on their own. Eliminating in-class preparation provided the opportunity to end each period with integrative group activities that connected laboratory and lecture material and explored clinical correlations. Materials provided for prelaboratory preparation included: custom-made, three-dimensional (3D) anatomy videos, abbreviated dissection instructions, key atlas figures, and dissection videos. Data from three years of the course (n = 241 students) allowed for analysis of students' preferences for these materials and detailed tracking of usage of 3D anatomy videos. Students reported spending an average of 27:22 (±17:56) minutes preparing for laboratory, similar to the 30 minutes previously allocated for in-class dissection preparation. The 3D anatomy videos and key atlas figures were rated the most helpful resources. Scores on laboratory examinations were compared for the three years before the curriculum change (2011-2013; n = 242) and three years after (2014-2016; n = 241). There was no change in average grades on the first and second laboratory examinations. However, on the final semi-cumulative laboratory examination, scores were significantly higher in the post-flip classes (P = 0.04). These results demonstrate an effective model for applying flipped classroom pedagogy to the gross anatomy laboratory and illustrate a meaningful role for 3D anatomy visualizations in a dissection-based course. Anat Sci Educ 11: 385-396. © 2017 American Association of Anatomists.

Pilot Study Evaluating the Impact of Otology Surgery Videos on Otolaryngology Resident Education

OBJECTIVES

Use of videos as educational tools is not a novel concept; however, there is a paucity of high-quality video resources available to otolaryngology trainees. We hypothesized that residents would deem surgical-videos using a multimedia-style format more valuable as preparatory tools. Aims of this study: 1) develop portfolio of otology/neurotology videos overviewing key steps, anatomy, and pearls by a senior surgeon; 2) have residents rate the effectiveness of the videos as a preoperative tool.

STUDY DESIGN

Prospective study.

METHODS

A video-library of procedures at (https://www.youtube.com/user/cisurgeon) was formatted via time-stamping to coincide expert level narration with closed captioning, critical procedural steps, relevant instrumentation, radiographic pictures, orientation cues, and anatomical highlights. Otolaryngology trainees of postgraduate years 2 through 5 (n = 13) watched a minimum of three videos and completed an assessment addressing: current resource identification/usefulness comparison, self-efficacy, impact on preparation time, and prioritization of resources.

RESULTS

The videos rated as highly useful compared with current resources (p = 0.002) and capable of promoting self-efficacy. Residents reported moderate-high prioritization of our multi-media formatted resource (scores >6) among their current preoperative regimen.

CONCLUSION

The varied videos were rated highly in terms of usefulness, promoting self-efficacy and as a high-priority for a resident's surgical preparation. Multimedia-formatted training videos should be further explored for this generation of electronic-learners. Future studies with a larger cohort, objective approaches, and multidisciplinary involvement are needed to determine the full impact of this education medium on surgical-training.

Video Review as a Tool to Improve Orthopedic Residents׳ Performance of Closed Manipulative Reductions

OBJECTIVE

Orthopedic residents commonly perform closed manipulative reductions as a part of their training. Traditionally, this skill is taught early in training but difficult to simulate. Proficiency is achieved through repetition and experience; faculty observation and instruction is unfortunately often limited. Direct resident teaching has been shown to increase competency, comfort, and long-term skill retention. We hypothesize that video review of closed fracture reductions will provide an inexpensive and valuable tool for resident education and improve skill performance.

DESIGN

Closed reductions performed by orthopaedic residents were recorded using a secured mobile tablet device in the emergency department (ED). Video review sessions were performed with both peer and faculty feedback/analysis of reduction technique. Anonymous resident and faculty surveys were completed following each session to evaluate the usage and perceived benefit of the program.

SETTING

University-based Level I Trauma Center.

PARTICIPANTS

Orthopedic surgery residents and faculty.

RESULTS

All junior orthopedic residents (postgraduate year [PGY] 1-3) reported that direct video observation by faculty was beneficial. Furthermore, 97% of junior resident and 100% of faculty responses reported that they would use this educational technology in the future. Residents and faculty both strongly agreed that video review was more useful than other methods, improved resident preparation for ED fracture care, and felt this technique would improve patient care and outcomes. Compared with senior residents (PGY 4-5), PGY-1s believed that this technique helped them prepare for ED fracture care (p = 0.02).

CONCLUSIONS

Video review provides a useful, innovative, and inexpensive method to improve resident competency in closed fracture reduction-a critical skill in orthopedic patient care. These procedures are uncommonly available for direct faculty observation. We have demonstrated that both residents and faculty were satisfied with the ability to review procedures, identify weaknesses, and obtain or provide direct feedback on this skill. Additionally, fracture reduction video review may help residents meet and achieve clinical milestones, an area of future investigation.

E-learning in orthopedic surgery training: A systematic review

E-learning is the use of internet-based resources in education. In the field of surgical education, this definition includes the use of virtual patient cases, digital modeling, online tutorials, as well as video recordings of surgical procedures and lectures. In recent years, e-learning has increasingly been considered a viable alternative to traditional teaching within a number of surgical fields. Here we present (1) a systematic review of literature assessing the efficacy of e-learning modules for orthopedic education and (2) a discussion of their relevance. A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted according to the guidelines defined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). The search yielded a total of 255 non-duplicate citations that were screened using predetermined inclusion/exclusion criteria. A total of 9 full text articles met inclusion criteria, which included the use of an objective outcome measure to evaluate an orthopedic e-learning module. Six studies assessed knowledge using a multiple-choice test and 4 assessed skills using a clinical exam. All studies showed positive score improvement pre- to post-intervention, and a majority showed greater score improvement than standard teaching methods in both knowledge (4/6 studies) and clinical skills (3/4 studies). E-learning represents an effective supplement or even alternative to standard teaching techniques within orthopedic education for both medical students and residents. Future work should focus on validating specific e-learning programs using standardized outcome measures and assessing long-term knowledge retention using e-learning platforms.

Moving Knowledge Acquisition From the Lecture Hall to the Student Home: A Prospective Intervention Study

BACKGROUND

Podcasts are popular with medical students, but the impact of podcast use on learning outcomes in undergraduate medical education has not been studied in detail.

OBJECTIVE

Our aim was to assess the impact of podcasts accompanied by quiz questions and lecture attendance on short- and medium-term knowledge retention.

METHODS

Students enrolled for a cardio-respiratory teaching module were asked to prepare for 10 specific lectures by watching podcasts and submitting answers to related quiz questions before attending live lectures. Performance on the same questions was assessed in a surprise test and a retention test.

RESULTS

Watching podcasts and submitting answers to quiz questions (versus no podcast/quiz use) was associated with significantly better test performance in all items in the surprise test and 7 items in the retention test. Lecture attendance (versus no attendance) was associated with higher test performance in 3 items and 1 item, respectively. In a linear regression analysis adjusted for age, gender, and overall performance levels, both podcast/quiz use and lecture attendance were significant predictors of student performance. However, the variance explained by podcast/quiz use was greater than the variance explained by lecture attendance in the surprise test (38.7% vs. 2.2%) and retention test (19.1% vs. 4.0%).

CONCLUSIONS

When used in conjunction with quiz questions, podcasts have the potential to foster knowledge acquisition and retention over and above the effect of live lectures.

Instructional video for teaching venepuncture

BACKGROUND

Safe venepuncture technique is a critical skill for health care professionals, to avoid accidental occupational injury. This study investigates whether watching an instructional video improves medical students' ability to perform venepuncture safely.

METHODS

This was a randomised, controlled, assessor-blinded trial that evaluated the utility of an instructional video, with the primary outcome of the ability to perform venepuncture safely. Forty-two second-year medical students were recruited and randomised to receive either video instruction (group A, n = 20) or no intervention (group B, n = 22). Prior to the study, all students attended an instructor-led workshop on venepuncture. During the study, students were paired and instructed to perform venepuncture on a partner. Performance was assessed using a points-based checklist. Pre- and post-study surveys were conducted to assess confidence with technique.

RESULTS

The mean total checklist score was higher in group A than in group B, with values of 14.15 and 9.18, respectively (p < 0.0001, maximum 18 points). Mean scores were also higher in group A than in group B among students who performed first (p = 0.008) and students who performed second (p = 0.005) within the pair. From the post-procedure survey, only group A rated increased confidence in performing venepuncture after the study (p = 0.008).

DISCUSSION

Students who watched an instructional video performed venepuncture more effectively and reported greater confidence with the technique. Medical students can benefit from having access to an instructional video on venepuncture as an adjunct to the standard curriculum. Safe venepuncture technique is a critical skill for health care professionals.