A novel method of teaching surgical techniques to residents--computerized enhanced visual learning (CEVL) with simulation to certify mastery of training: a model using newborn clamp circumcision.
OBJECTIVE
To assess the learning process of combining a web-based video of a simulated surgical procedure with a step-by-step checklist of the same procedure in achieving competency of the simulated technique, in this case a newborn clamp circumcision. Fundamental to this particular learning process is immediate mentor step-by-step feedback which specifically follows the procedure's step-by-step checklist.


METHODS
Pediatric residents naïve to newborn circumcision were enrolled (n = 7). A circumcision simulator, instruments, and web access to the learning module were provided. Residents trained independently and then performed two simulations with the mentor. The first simulation was completed with formative scored feedback. The learner then performed a second scored simulation.


RESULTS
All learners showed improvement between the first and second simulation (mean 85.3-97.4). All residents achieved competency (96/100 or greater) by the second simulation. On post-procedure surveys, learners demonstrated increased comfort and reduced apprehension in performing the procedure.


CONCLUSIONS
Combining a web-accessible video of a procedure, a checklist, and a simulator followed by a single mentor session with immediate formative feedback which follows the steps of the checklist is a useful method to teach the simulation technique of circumcision. We plan to study if this paradigm is transferable to clinical circumcision.
University of North Carolina School of Medicine, North Carolina, United States.
Angela
A
Smith
Max
M
Maizels
Ruslan
R
Korets
John S
JS
Wiener
Michael
M
Stiener
Dennis B
DB
Liu
Richard W
RW
Sutherland
D057189:Checklist; D002944:Circumcision, Male / Q000193:education*; D003162:Competency-Based Education / Q000379:methods*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods*; D005246:Feedback; D006801:Humans; D007231:Infant, Newborn; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D013525:Surgical Instruments
CEVL; Circumcision; Computer-assisted instruction; Education; F/R; ROSe; RTP; Recording Of Skills evaluation; Residency; Residency Training Program; computer enhanced visual learning; feedback/remediation