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Nathan A, Fricker M, Georgi M, Patel S, Hang MK, Asif A, Sinha A, Mullins W, Shea J, Hanna N, Monks M, Peprah D, Sharma A, Ninkovic-Hall G, Lamb BW, Kelly J, Sridhar A, Collins JW. Virtual Interactive Surgical Skills Classroom: A Parallel-group, Non-inferiority, Adjudicator-blinded, Randomised Controlled Trial (VIRTUAL). JOURNAL OF SURGICAL EDUCATION 2022; 79:791-801. [PMID: 34857499 DOI: 10.1016/j.jsurg.2021.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/05/2021] [Accepted: 11/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study evaluated the efficacy of virtual classroom training (VCT) in comparison to face-to-face training (FFT) and non-interactive computer-based learning (CBL) for basic surgical skills training. DESIGN This was a parallel-group, non-inferiority, prospective randomised controlled trial with three intervention groups conducted in 2021. There were three intervention groups with allocation ratio 1:1:1. Outcome adjudicators were blinded to intervention assignment. Interventions consisted of 90-minute training sessions. VCT was delivered via the BARCO weConnect platform, FFT was provided in-person by expert instructors and CBL was carried out by participants independently. The primary outcome was post-intervention Objective Structured Assessment of Technical Skills score, adjudicated by two experts and adjusted for baseline proficiency. The assessed task was to place three interrupted sutures with hand-tied knots. SETTING This multicentre study recruited from five medical schools in London. PARTICIPANTS Inclusion criteria were medical student status and access to a personal computer and smartphone. One hundred fifty-nine eligible individuals applied online. Seventy-two participants were randomly selected and stratified by subjective and objective suturing experience prior to permuted block randomization. RESULTS Twenty-four participants were allocated to each intervention, all were analysed per-protocol. The sample was 65.3% female with mean age 21.3 (SD 2.1). VCT was non-inferior to FFT (adjusted difference 0.44, 95% CI: -0.54 to 1.75, delta 0.675), VCT was superior to CBL (adjusted difference 1.69, 95% CI: 0.41-2.96) and FFT was superior to CBL (adjusted difference 1.25, 95% CI: 0.20-2.29). The costs per-attendee associated with VCT, FFT and CBL were £22.15, £39.69 and £16.33 respectively. Instructor hours used per student for VCT and FFT were 0.25 and 0.75, respectively. CONCLUSIONS VCT provides greater accessibility and resource efficiency compared to FFT, with similar educational benefit. VCT has the potential to improve global availability and accessibility of surgical skills training.
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Affiliation(s)
- Arjun Nathan
- Division of Surgery and Interventional Science, University College London, London, United Kingdom.
| | - Monty Fricker
- School of Medicine, Newcastle University, Newcastle, United Kingdom
| | - Maria Georgi
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Sonam Patel
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Man Kien Hang
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Aqua Asif
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Amil Sinha
- School of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - William Mullins
- School of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jessie Shea
- School of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Nancy Hanna
- School of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Massimo Monks
- Department of Surgery, North Middlesex University Hospitals NHS Foundation Trust, London, United Kingdom
| | - David Peprah
- Department of Surgery, North Middlesex University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Akash Sharma
- Department of Radiology, Imperial College London, London, United Kingdom
| | - George Ninkovic-Hall
- Department of Surgery, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Benjamin W Lamb
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - John Kelly
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Ashwin Sridhar
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Justin W Collins
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
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