title: Surgical skill acquisition with self-directed practice using computer-based video training.
abstract: BACKGROUND
  Computer-based video training (CBVT) provides flexible opportunities for surgical trainees to learn fundamental technical skills, but may be ineffective in self-directed practice settings because of poor trainee self-assessment. This study examined whether CBVT is effective in a self-directed learning environment among novice trainees.
  
  
  METHODS
  Thirty novice trainees used CBVT to learn the 1-handed square knot while self-assessing their proficiency every 3 minutes. On reaching self-assessed skill proficiency, trainees were randomized to either cease practice or to complete additional practice. Performance was evaluated with computer and expert-based measures during practice and on pretests, posttests, and 1-week retention tests.
  
  
  RESULTS
  Analyses revealed performance improvements for both groups (all P < .05), but no differences between the 2 groups (all P > .05) on all tests.
  
  
  CONCLUSIONS
  CBVT for the 1-handed square knot is effective in a self-directed learning environment among novices. This lends support to the implementation of self-directed digital media-based learning within surgical curricula.
authors.affiliation: Department of Surgery, University of Toronto, Surgical Skills Centre at Mount Sinai Hospital, 600 University Avenue, Level 2, Room 250, Ontario, Canada M5G 1x5.
authors.forename: Nathan
authors.initials: N
authors.lastname: Jowett
authors.forename: Vicki
authors.initials: V
authors.lastname: LeBlanc
authors.forename: George
authors.initials: G
authors.lastname: Xeroulis
authors.forename: Helen
authors.initials: H
authors.lastname: MacRae
authors.forename: Adam
authors.initials: A
authors.lastname: Dubrowski
mesh_terms: D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D006801:Humans; D012655:Self-Evaluation Programs; D013514:Surgical Procedures, Operative / Q000193:education*; D013536:Suture Techniques / Q000193:education; D014741:Video Recording