Development and evaluation of cesarean section surgical training using computer-enhanced visual learning*. (November 2014)

• Record Type: Journal Article
• Authors: York, Sloane L.; Maizels, Max; Cohen, Elaine; Stoltz, Rachel Stork; Jamil, Adeel; Mcgaghie, William C.; Gossett, Dana R.
• Is Part Of: Medical teacher. Volume 36:Number 11(2014)
• Page Start: 958
• Page End: 964
• Publication Date: 2014-11
• Subjects: Medical education -- Periodicals; 610.711
• DOI: 10.3109/0142159X.2014.917156
• Languages: English
• ISSNs: 0142-159X

Abstract

<abstract> <title>Abstract</title> <p> <bold>Background</bold>: Skilled performance of cesarean deliveries is essential in obstetrics and gynecology residency. A computer-enhanced visual learning module (CEVL Cesarean) was developed to teach cesarean deliveries.</p> <p> <bold>Methods</bold>: An online module presented cesarean deliveries as a series of components using text, audio, video and animation. First-year residents used CEVL Cesarean and were evaluated intra-operatively by trained raters, then provided feedback about surgical performance. Clinical outcomes were collected for approximately 50 cesarean deliveries for each resident.</p> <p> <bold>Results</bold>: From 2010 to 2011, 12 first-year residents participated in the study. About 406 unique observed cesarean deliveries were analyzed. Procedures up to each resident's 70th case were analyzed by grouping cases in 10 s (cases 1–10 and 11–20), or deciles. Resident performance significantly improved by decile [χ<sup>2</sup>(6) = 47.56, <italic>p</italic> < 0.001]. When examining each resident's performance, surgical skill acquisition plateaued by cases 21–30. Procedural performance, independent of resident, also improved significantly by decile [χ<sup>2</sup>(6) = 186.95, <italic>p</italic> < 0.001], plateauing by decile 4 (cases 31–40). Throughout the observation period, operative time decreased by 3.84 min (<italic>p</italic> = 0.006).</p> <p> <bold>Conclusions</bold>: Pre-clinical teaching using computer-based modules for cesarean sections is feasible to develop. Novice surgeons required at least 30 procedures before performing the procedure competently. When residents performed competently, operative time and complications decreased.</p> </abstract>