Comparison of text versus video for teaching laparoscopic knot tying in the novice surgeon: a randomized, controlled trial.
BACKGROUND
Video seems advantageous over traditional text as an educational tool in conceptually-based procedures such as laparoscopy. However, this has never been tested directly.


OBJECTIVE
The purpose of this study was to compare the use of text versus video as an educational tool for laparoscopic training, through a randomized controlled trial.


METHODS
Prospective, randomized, controlled clinical trial (Canadian Task Force classification I).


METHODS
Eighty (n = 80) medical students, who had no experience with tying a laparoscopic intracorporeal knot, were randomly taught to do so by either reading a text with accompanying pictures (n = 40) or watching a short video with audio of comparable content (n = 40). The participants were allowed to review the material for as long as they needed to achieve understanding of the procedure. They were then asked to tie a laparoscopic square knot in a box trainer, with a limit time of 15 minutes. Time to review the educational material(s), time to tie the knot(s), numbers of attempts at the task (n), and numbers of those who expressed understanding of the task (n) were recorded.


RESULTS
The number of participants who were able to complete the knot (n = 14 text v. n = 18 video, p = 0.49) and the average time needed for completion (479 s text v.494 s video, p = 0.38) were not statistically different in the two groups. However, time to review the material (407 s text v. 258 s video, p < 0.001), number of attempts at the task (15 text v. 5 video had n>2 attempts, p = 0.01), and number of those who expressed understanding when they could not complete the task (35% text v. 59% video, p = 0.047) were statistically different.


CONCLUSIONS
This is the first randomized trial evaluating video alone as an educational tool in laparoscopic training. It demonstrates that video is superior to text in achieving superior conceptual understanding, without improving operative times. Understanding through video instruction cannot make up for a lack of technical ability in novice surgeons.
Yeung
Patrick
P
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics & Gynecology, Duke University, Durham, NC 27704, USA. patrick.yeung@duke.edu
Justice
Tiffany
T
Pasic
Resad Paya
RP
D000328:Adult; D002983:Clinical Competence; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011380:Programmed Instructions as Topic; D011446:Prospective Studies; D013536:Suture Techniques / Q000193:education*; D014741:Video Recording; D055815:Young Adult