Thesis Final Poster Kaitlyn Gonsalves

Thesis Final Poster Kaitlyn Gonsalves

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  Investigating Learning Methodsfor Surgical Procedures within Orthopaedic Residency Education Kaitlyn Gonsalves1 B.Sc Natalie Wagner B.Sc1,2, Colm McCarthy M.D2,, Ranil Sonnadara, Ph.D1,2 McMaster University. Department of Psychology, Neuroscience & Behaviour1, Department of Surgery2 • Postgraduate surgical residency programs currently require residents to spend a fixed period of time learning through the mentor-apprentice approach before graduating. This is known as the time-spent model.1,2 • Recent changes to the healthcare system threaten this time-spent model. Reductions to trainee work hours, a push for clinical and operating room efficiency, and clinical staff who have limited time to teach residents have resulted in limited exposure to direct observation of surgical cases and less teaching time for residents.3 • Since surgical trainees are no longer able to gain enough experience through the traditional approach, medical educators are seeking alternate teaching methods to use as an adjunct to direct operating room (OR) observation.2 • Alternate teaching methods should focus on how residents learn and understand complex information. Computer- based video instruction (CBVI) and multimedia instruction has been successful in teaching medical student specific surgical skills, such as suturing.4 • Using multimedia instruction can benefit residents who have limited time in the OR, an alternative learning method for residents could be to learn complex surgical procedures through video-based instruction. BACKGROUND OBJECTIVES METHODS 1. Hodges, B. (2010). A Tea-Steeping or i-Doc Model for Medical Education? Academic Medicine, 85, S34–S44. 2. Sonnadara, R. R., Mui, C., McQueen, S., Mironova, P., Nousiainen, M., Safir, O., … Reznick, R. (2014). Reflections on competency-based education and training for surgical residents. Journal of Surgical Education, 71(1), 151–158. 3. Irby, D. M., Cooke, M., & O'Brien, B. C. (2010). Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Academic Medicine, 85(2), 220-227. 4. Dubrowski, A., & Xeroulis, G. (2005). Computer‐based Video Instructions for Acquisition of Technical Skills. Journal of Visual Communication in Medicine, 28(4), 150–155. • The results suggest there is no significant difference in the effectiveness of studying complex surgeries from a textbook or video resource. Both learning modalities significantly improved quiz scores over time. • To describe the differences between Group A and Group B, multiple factors were considered: their post-graduate year (PGY), previous experience, and if they completed any of the 4 surgeries from study date until retention test date. It is possible these factors, among others, could contribute to the quiz scores. Conclusion • Since textbook and video methods provide similar learning outcomes, future studies can investigate residents using a combination of both methods as teaching tools for a greater understanding of complex surgeries. RESULTS DISCUSSION REFERENCES TIMELINE GROUP A GROUP B DAY 1 (February 7th 2016) Ankle Fracture Fixation (text) Ankle Fracture Fixation (video) Shoulder Arthroplasty (video) Shoulder Arthroplasty (text) DAY 2 (February 17th 2016) Elbow Arthroscopy (video) Elbow Arthroscopy (text) ACL Repair (text) ACL Repair (video) DAY 3 RETENTION TEST (March 8th–12th 2016) LimeSurvey Quiz: Ankle Fracture Fixation Shoulder Arthroplasty Elbow Arthroscopy ACL Repair LimeSurvey Quiz: Ankle Fracture Fixation Shoulder Arthroplasty Elbow Arthroscopy ACL Repair ACKNOWLEDGMENTS • The hypothesis states that if video learning tools are effective for teaching surgical skills, then residents video learning tools should show higher scores across all surgical procedures. • This study compares the effectiveness of textbook readings to computer-based videos in teaching complex surgical procedures. Research Question • Is computer-based video instruction (CBVI) an effective tool for teaching complete and complex surgeries in surgical residency programs? I would like to thank my family and friends for their unwavering support, the entire Sonnadara lab, our peers in the Department of Surgery, the residents who participated, the MultiSensory Perception Lab and my close friends—all who have undoubtedly encouraged and supported me through this project. A special thank you to Dr. Ranil Sonnadara, Dr. David Shore, Natalie Wagner, and Brendan Stanley for being pillars of support. Thank you for your expertise, your kindness, and your wisdom throughout this journey. I am infinitely thankful and grateful. • Participants completed a demographics questionnaire to gauge past experience. • Baseline quizzes were given prior to study period, knowledge quizzes were given after the study period, and retention quizzes were completed one month later. • To assess the primary research question, a repeated measures ANOVA was conducted in SPSS. The results suggest a main effect of time, F(2,18) = 10.30, p = 0.001. All other factors were insignificant. • Data from day 2 was excluded from the analysis as there was a large imbalance between Group A and B. 47% 68% 62%43% 80% 47% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Baseline Quiz Knowledge Quiz Retention Quiz QUIZSCORE TIME Ankle Fracture Procedure Group A (text) Group B (video) 56% 68% 68% 39% 71% 63% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Baseline Quiz Knowledge Quiz Retention Quiz QUIZSCORE TIME Shoulder Arthroplasty Procedure Group A (video) Group B (text) 47% 68% 62% 43% 80% 47% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Baseline Quiz Knowledge Quiz Retention Quiz QUISCORE TIME Ankle Fracture Procedure Group A (text) Group B (video) 56% 68% 68% 39% 71% 63% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Baseline Quiz Knowledge Quiz Retention Quiz QUIZSCORE TIME Shoulder Arthroplasty Procedure Group A (video) Group B (text)