title: Verbal feedback from an expert is more effective than self-accessed feedback about motion efficiency in learning new surgical skills.
abstract: BACKGROUND
  Teaching of technical surgical skills to undergraduate medical students in a laboratory setting away from the patient is not common practice. Because of the large volume of students and shortage of available teaching faculty new methods of teaching must be developed for this group of trainees. In this study we examined the effectiveness of computer-based video training, different types of computer-based motion efficiency feedback (with and without expert criteria), and expert feedback on learning of a basic technical skill in medical students.
  
  
  METHODS
  Forty-five junior medical students were randomized into 3 groups and learned suturing and knot-tying skills. Group A received computer-generated feedback about the economy of their movements. Group B received the same motion economy feedback, as well as expert reference values. Group C received verbal feedback from an expert. All groups were pre-tested, allowed 18 practice trials, and post-tested, and their skill retention was retested after 1 month. Performance was assessed by expert analysis using an objective structured analysis of technical skill and by computer analysis (Imperial College Surgical Assessment Device [ICSAD]).
  
  
  RESULTS
  All groups showed improvement from pre-test to post-test. However, only group C showed retention of skill on delayed performance testing.
  
  
  CONCLUSIONS
  Verbal feedback from an expert instructor led to lasting improvements in technical skills performance. Providing information about motion efficiency did not lead to similar improvements.
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Porte
authors.forename: George
authors.initials: G
authors.lastname: Xeroulis
authors.forename: Richard K
authors.initials: RK
authors.lastname: Reznick
authors.forename: Adam
authors.initials: A
authors.lastname: Dubrowski
mesh_terms: D001676:Biofeedback, Psychology; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D003626:Data Display; D004504:Education, Medical, Undergraduate / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D011361:Professional Competence; D015203:Reproducibility of Results; D012647:Self-Assessment; D013536:Suture Techniques / Q000193:education*; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods*; D014584:User-Computer Interface; D014706:Verbal Learning