A new teaching method to improve clinical skills of suture techniques for undergraduate medical students by introducing motivation theory and flipped classroom approach

10.6145/jme201712

Hui-Ying Low；Kuo-Shu Huang；Yi-Lun Chen；Hui-Chin Chang；Ming-Che Tsai；Ming-Yu Hsieh

suture workshop ； flipped classroom ； computer-aided video instruction ； competition ； motivation theory

Journal of Medical Education

21卷3期（2017 / 09 / 01）

114 - 123

英文

Background: All doctors need to develop a core of basic surgical skills, whether or not they eventually specialize as surgeons. However, mastering surgical skills requires sustained deliberate practice, usually over several years. Ideally, this training should start early in undergraduate years and be reinforced at intervals. Nowadays, a combination of computer-aided video instruction, flipped classroom and competition is well established in medical education and is ideal for learning surgical techniques and it encourages regular practice, in preparation for supervised clinical experience when the basics have been mastered. Objectives: to evaluate the performance of suture skills including knot-tying techniques of undergraduate medical students after the combination of computer-aided video instructions, flipped classroom and competition compared with previous passing rate. Material and methods: This study analyzed the performance of suture skills including knot tying and suturing techniques of undergraduate medical students who are year 5 students (clerkship) after using computer-aided video instructions. Participants were pre-tested on a knot-tying skill after viewing an instructional video. First of all, they have learnt surgical procedures after watching a clinical video for preparation over a period of one week and next to compete with each other by doing the procedure on a model and on a patient under supervision in a certain time limit. The best one-third of students of each group can get a special badge. The effectiveness of training was assessed both at an immediate post-test 3 weeks after video learning without it being compulsory. During the workshop, students were tested for both one-handed and two-handed surgical knot tying. The best record is recorded as competition. Performance was evaluated by using both expert-based evaluation and compared with previous suture workshop passing rates. Data were analyzed using students' t-test and p value that are less than 0.05 significant differences. The surgical tying technique of students was significantly improved after preparation by computer- aided video simulation and flipped classroom. On the other hand, we also discovered that we can save both time and human resources in suture workshops compared to previous workshops. Thoughtfully incorporated into technical curricula, computer-aided video instruction can make efficient use of faculty time and serve as a useful pedagogic adjunct for basic skills training. Result and conclusion: Our results showed that through computer-aided video instructions, the concept of flipped classroom, and competition, we can save money and human resources and also improve the surgical technique of undergraduate medical students. This study confirms that it can provide excellent opportunities for the integration of clinical medicine and surgical skills into the early clinical training of undergraduate medical students.

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