title: Use of mobile learning module improves skills in chest tube insertion.
abstract: BACKGROUND
  Just-In-Time Learning is a concept increasingly applied to medical education, and its efficacy must be evaluated.
  
  
  METHODS
  A 3-minute video on chest tube insertion was produced. Consenting participants were assigned to either the video group, which viewed the video on an Apple® iPod Touch immediately before chest tube insertion, or the control group, which received no instruction. Every participant filled out a questionnaire regarding prior chest tube experience. A trained clinician observed participants insert a chest tube on the TraumaMan® task simulator, and assessed performance using a 14-item skills checklist.
  
  
  RESULTS
  Overall, 128 healthcare trainees participated, with 50% in the video group. Participants included residents (34.4%, n = 44), medical students (32.8%, n = 42), and U.S. Army Forward Surgical Team members (32.8%, n = 42). Sixty-nine percent of all participants responded that they had never placed a chest tube, but 7% had placed more than 20. Only 25% of the participants had previously used TraumaMan®. Subjects who viewed the video scored better on the skills checklist than the control group (11.09 ± 3.09 versus 7.17 ± 3.56, P < 0.001, Cohen's D = 1.16). Medical students (9.33 ± 2.65 versus 4.52 ± 3.64, P < 0.001), Forward Surgical Team members (10.07 ± 2.52 versus 8.57 ± 3.22, P < 0.001), anesthesia residents (8.25 ± 2.56 versus 5.9 ± 2.23, P = 0.017), and subjects who had placed fewer than 10 chest tubes (9.7 ± 3 versus 6.6 ± 3.9, P < 0.001) performed significantly better with the video.
  
  
  CONCLUSIONS
  The procedural animation video is an effective medium for teaching procedural skills. Embedding the video on a mobile device, and allowing trainees to access it immediately before chest tube insertion, may enhance and standardize surgical education for civilians and military personnel.
authors.affiliation: University of Miami Leonard M. Miller School of Medicine, Department of Surgery, Miami, Florida 33101, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Davis
authors.forename: George D
authors.initials: GD
authors.lastname: Garcia
authors.forename: Mary M
authors.initials: MM
authors.lastname: Wyckoff
authors.forename: Salman
authors.initials: S
authors.lastname: Alsafran
authors.forename: Jill M
authors.initials: JM
authors.lastname: Graygo
authors.forename: Kelly F
authors.initials: KF
authors.lastname: Withum
authors.forename: Carl I
authors.initials: CI
authors.lastname: Schulman
mesh_terms: D015505:Chest Tubes; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008348:Manikins; D008887:Military Medicine / Q000193:education; D018794:Problem-Based Learning; D013907:Thoracostomy / Q000193:education*; D014741:Video Recording