title: A prospective, blinded evaluation of a video-assisted '4-stage approach' during undergraduate student practical skills training.
abstract: BACKGROUND
  The 4-stage approach (4-SA) is used as a didactic method for teaching practical skills in international courses on resuscitation and the structured care of trauma patients. The aim of this study was to evaluate objective and subjective learning success of a video-assisted 4-SA in teaching undergraduate medical students.
  
  
  METHODS
  The participants were medical students learning the principles of the acute treatment of trauma patients in their multidiscipline course on emergency and intensive care medicine. The participants were quasi- randomly divided into two groups. The 4-SA was used in both groups. In the control group, all four steps were presented by an instructor. In the study group, the first two steps were presented as a video. At the end of the course a 5-minute objective, structured clinical examination (OSCE) of a simulated trauma patient was conducted. The test results were divided into objective results obtained through a checklist with 9 dichotomous items and the assessment of the global performance rated subjectively by the examiner on a Likert scale from 1 to 6.
  
  
  RESULTS
  313 students were recruited; the results of 256 were suitable for analysis. The OSCE results were excellent in both groups and did not differ significantly (control group: median 9, interquantil range (IQR) 8-9, study group: median 9, IQR 8-9; p = 0.29). The global performance was rated significantly better for the study group (median 1, IQR 1-2 vs. median 2, IQR 1-3; p < 0.01). The relative knowledge increase, stated by the students in their evaluation after the course, was greater in the study group (85% vs. 80%).
  
  
  CONCLUSIONS
  It is possible to employ video assistance in the classical 4-SA with comparable objective test results in an OSCE. The global performance was significantly improved with use of video assistance.
authors.forename: Katrin
authors.initials: K
authors.lastname: Schwerdtfeger
authors.forename: Saskia
authors.initials: S
authors.lastname: Wand
authors.forename: Oliver
authors.initials: O
authors.lastname: Schmid
authors.forename: Markus
authors.initials: M
authors.lastname: Roessler
authors.forename: Michael
authors.initials: M
authors.lastname: Quintel
authors.forename: Kay B
authors.initials: KB
authors.lastname: Leissner
authors.affiliation: Department of Anaesthesiology, University Hospital Göttingen, Göttingen 37075, Germany. s.russo@medizin.uni-goettingen.de.
authors.forename: Sebastian G
authors.initials: SG
authors.lastname: Russo
mesh_terms: D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D004521:Educational Measurement; D006801:Humans; D008297:Male; D015397:Program Evaluation; D011446:Prospective Studies; D012151:Resuscitation / Q000193:education; D016037:Single-Blind Method; D013337:Students, Medical; D013663:Teaching / Q000379:methods; D014741:Video Recording; D014947:Wounds and Injuries / Q000628:therapy