Asynchronous Unsupervised Video-Enhanced Feedback As Effective As Direct Expert Feedback in the Long-Term Retention of Practical Clinical Skills: Randomised Trial Comparing 2 Feedback Methods in a Cohort of Novice Medical Students.

OBJECTIVES: To determine the degree of practical clinical skills' retention over a 7-week period after receiving either video-enhanced direct expert feedback (DEF) or asynchronous unsupervised video-enhanced feedback (UVF). DESIGN: A prospective single-blinded randomized trial was conducted over a 7-week period with novice medical students. Following a generic introduction, PowerPoint presentation and live demonstration of intravenous cannulation was given by an expert, and candidates performed the same task in isolation while being recorded and were randomized to receive either DEF or UVF. Further, 20 students were randomized to receive UVF and 22 to receive DEF. Candidates returned to repeat the video-recorded task at week 1, 4, and 7, with no further feedback provision on these occasions. Performances were fully anonymized and independently marked by 2 expert assessors. SETTING: Newcastle University, Medical School, England, United Kingdom. PARTICIPANTS: A total of 42 novice medical students from the preclinical years were selected, with no prior experience of intravenous cannulation. RESULTS: No significant difference existed between demographics of either cohort. Good between-assessor score correlation was noted, with an intraclass correlation coefficient (ICC) of 0.89. The DEF arm significantly improved from their prefeedback performance at Day 1 on repeating the skill a week later (p < 0.0001); this improved score was maintained throughout the duration of the study. The UVF arm showed a nonsignificant improvement; however, there was no significant difference in the scores between the UVF and the DEF groups at any point in the trial. CONCLUSIONS: Video-technology may play a significant role in the provision of feedback for practical skills. The ability for experts to provide remotely delivered but individualized feedback can be an efficient use of valuable resources, while students being able to self-assess their own performance alongside an expert video have the potential to provide students with an excellent opportunity to learn clinical skills without requiring intensive educator involvement.

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

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.

Surgical Trainers' Experience and Perspectives on Workplace-Based Assessments.

BACKGROUND: Workplace-based assessments (WBAs) were designed to provide formative feedback to trainees throughout their surgical career. Several studies highlight dissatisfaction with WBAs, and some feel they lack validity and reliability and exist as a "tick-box exercise." No studies have looked at the attitudes of the assessor. AIM: The aim of this study was to evaluate perceptions and experience of the 4 intercollegiate surgical curriculum programme WBAs by assessors. METHODS: An 18-item electronic questionnaire, including 6-point Likert scoring questions, was e-mailed to all surgical program directors for distribution to general surgery trainers within their deanery. RESULTS: In total, 64 responses were received. All trainers had been trained in using WBAs. Trainers had the most experience with procedure-based assessments (PBAs)-72% of trainers had completed more than 25 PBAs. Trainers felt PBAs were the most beneficial WBA, and both PBAs and case-based discussions were regarded as significantly more useful than mini-clinical evaluation exercise (p < 0.05). More than 74% stated that WBAs were mainly initiated by trainees, and only 10% had specific sessions allocated to complete WBAs. CONCLUSION: WBAs are regarded as beneficial to trainees. The results suggest that assessors feel case-based discussions and PBAs, which assess higher thinking and practice of complex practical skills, respectively, are significantly more useful than assessments involved in observing more straightforward clinical and procedural interactions.