title: Role of instruction method in novices' acquisition of minimally invasive surgical basic skills.
abstract: BACKGROUND
  We investigated the impact of instruction method on novices' acquisition of minimally invasive surgical (MIS) basic skills.
  
  
  METHODS
  One hundred five novice medical students underwent text-based (TB), video-based (VB), or faculty-tutored (FT) single-session instruction in three basic MIS skill tasks on a box trainer. Pre- and postsession, participants completed a 12-item, 5-point Likert-type scale (1=Not confident at all, 5=Completely confident) of self-efficacy for performing basic MIS skills and had performances on each task recorded. Four raters evaluated every video performance of one task, a two-handed peg transfer, using a 16-cm visual analog measurement (VAM). Inter-rater reliability was good (intra-class correlation coefficient=0.82). The relationship between instruction method, self-efficacy mean score change, and mean VAM change was examined using ANOVA analysis.
  
  
  RESULTS
  Eighty-five participants (TB=32, VB=24, FT=29) had valid matched data. Mean scores in self-efficacy and task performance increased from pre- to postsession for every instruction method: (1) Δ self-efficacy=1.04±0.64 (TB), 1.36±0.69 (VB), and 1.41±0.82 (FT); (2) Δ VAM=3.77±2.87 (TB), 3.82±2.35 (VB), and 2.57±2.60 (FT). Analysis of variance revealed no relationship between instruction method and self-efficacy (P=.10) or VAM mean score change (P=.14).
  
  
  CONCLUSIONS
  Self-directed instruction methods (e.g., TB and VB) for novices' acquisition of MIS basic skills offer flexible, learner-centered, and cost-effective alternatives to the more expensive FT method.
authors.affiliation: Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. jpaige@lsuhsc.edu
authors.forename: John T
authors.initials: JT
authors.lastname: Paige
authors.forename: Tong
authors.initials: T
authors.lastname: Yang
authors.forename: Rabiya
authors.initials: R
authors.lastname: Suleman
authors.forename: Sheila
authors.initials: S
authors.lastname: Chauvin
authors.forename: Jaime
authors.initials: J
authors.lastname: Alleyn
authors.forename: Martha
authors.initials: M
authors.lastname: Brewer
authors.forename: Rodney
authors.initials: R
authors.lastname: Hoxsey
mesh_terms: D001296:Audiovisual Aids; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D013337:Students, Medical; D013663:Teaching / Q000379:methods*; D014584:User-Computer Interface; D014741:Video Recording