COMPUTER-ASSISTED-LEARNING VERSUS A LECTURE AND FEEDBACK SEMINAR FOR TEACHING A BASIC SURGICAL TECHNICAL SKILL

BACKGROUND: Rapid improvements in computer technology allow us to cons ider the use of computer-assisted learning (CAL) for teaching technica l skills in surgical training. The objective of this study was to comp are in a prospective, randomized fashion, CAL with a lecture and feedb ack seminar (LFS) for the purpose of teaching a basic surgical skill. METHODS: Freshman medical students were randomly assigned to spend 1 h our in either a CAL or LFS session. Both sessions were designed to tea ch them to tie a two-handed square knot. Students in both groups were given knot tying boards and those in the CAL group were asked to inter act with the CAL program. Students in the LFS group were given a slide presentation and were given individualized feedback as they practiced this skill. At the end of the session the students were videotaped ty ing two complete knots. The tapes were independently analyzed, in a bl inded fashion, by three surgeons. The total time for the task was reco rded, the knots were evaluated for squareness, and each subject was sc ored for the quality of performance. RESULTS: Data from 82 subjects we re available for the final analysis. Comparison of the two groups demo nstrated no significant difference between the proportion of subjects who were able to tie a square knot. There was no difference between th e average time required to perform the task. The CAL group had signifi cantly lower quality of performance (t = 5.37, P < 0.0001), CONCLUSION S: CAL and LFS were equally effective in conveying the cognitive infor mation associated with this skill. However, the significantly lower pe rformance score demonstrates that the students in the CAL group did no t attain a proficiency in this skill equal to the students in the LFS group. Comments by the students suggest that the lack of feedback in t his model of CAL was the significant difference between these two educ ational methods. (C) 1998 by Excerpta Medica, Inc.