title: Teaching surgical skills using video internet communication in a resource-limited setting.
abstract: OBJECTIVE
  To study the feasibility and acceptability of using video Internet communication to teach and evaluate surgical skills in a low-resource setting.
  
  
  METHODS
  This case-controlled study used video Internet communication for surgical skills teaching and evaluation. We randomized intern physicians rotating in the Obstetrics and Gynecology Department at Mulago Hospital at Makerere University in Kampala, Uganda, to the control arm (usual practice) or intervention arm (three video teaching sessions with University of California, San Francisco faculty). We made preintervention and postintervention videos of all interns tying knots using a small video camera and uploaded the files to a file hosting service that offers cloud storage. A blinded faculty member graded all of the videos. Both groups completed a survey at the end of the study.
  
  
  RESULTS
  We randomized 18 interns with complete data for eight in the intervention group and seven in the control group. We found score improvement of 50% or more in six of eight (75%) interns in the intervention group compared with one of seven (14%) in the control group (P=.04). Scores declined in five of the seven (71%) controls but in none in the intervention group. Both intervention and control groups used attendings, colleagues, and the Internet as sources for learning about knot-tying. The control group was less likely to practice knot-tying than the intervention group. The trainees and the instructors felt this method of training was enjoyable and helpful.
  
  
  CONCLUSIONS
  Remote teaching in low-resource settings, where faculty time is limited and access to visiting faculty is sporadic, is feasible, effective, and well-accepted by both learner and teacher.
  
  
  METHODS
  II.
authors.affiliation: Departments of Obstetrics, Gynecology, and Reproductive Sciences, and Anesthesia, University of California, San Francisco, San Francisco, California, and the Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University, Kampala, Uganda.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Autry
authors.forename: Sharon
authors.initials: S
authors.lastname: Knight
authors.forename: Felicia
authors.initials: F
authors.lastname: Lester
authors.forename: Gerald
authors.initials: G
authors.lastname: Dubowitz
authors.forename: Josaphat
authors.initials: J
authors.lastname: Byamugisha
authors.forename: Yosam
authors.initials: Y
authors.lastname: Nsubuga
authors.forename: Mark
authors.initials: M
authors.lastname: Muyingo
authors.forename: Abner
authors.initials: A
authors.lastname: Korn
mesh_terms: D016022:Case-Control Studies; D002983:Clinical Competence; D003142:Communication; D020375:Education, Distance; D004501:Education, Medical / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006295:Health Resources; D006801:Humans; D020407:Internet; D007396:Internship and Residency; D007858:Learning; D012495:San Francisco; D014454:Uganda; D014743:Videotape Recording / Q000379:methods*