title: Development and evaluation of cesarean section surgical training using computer-enhanced visual learning.
abstract: BACKGROUND
  Skilled performance of cesarean deliveries is essential in obstetrics and gynecology residency. A computer-enhanced visual learning module (CEVL Cesarean) was developed to teach cesarean deliveries.
  
  
  METHODS
  An online module presented cesarean deliveries as a series of components using text, audio, video and animation. First-year residents used CEVL Cesarean and were evaluated intra-operatively by trained raters, then provided feedback about surgical performance. Clinical outcomes were collected for approximately 50 cesarean deliveries for each resident.
  
  
  RESULTS
  From 2010 to 2011, 12 first-year residents participated in the study. About 406 unique observed cesarean deliveries were analyzed. Procedures up to each resident's 70th case were analyzed by grouping cases in 10 s (cases 1-10 and 11-20), or deciles. Resident performance significantly improved by decile [χ(2)(6) = 47.56, p < 0.001]. When examining each resident's performance, surgical skill acquisition plateaued by cases 21-30. Procedural performance, independent of resident, also improved significantly by decile [χ(2)(6) = 186.95, p < 0.001], plateauing by decile 4 (cases 31-40). Throughout the observation period, operative time decreased by 3.84 min (p = 0.006).
  
  
  CONCLUSIONS
  Pre-clinical teaching using computer-based modules for cesarean sections is feasible to develop. Novice surgeons required at least 30 procedures before performing the procedure competently. When residents performed competently, operative time and complications decreased.
authors: Rush University Medical Center, Chicago, IL , USA .
authors: Sloane L
authors: SL
authors: York
authors: Max
authors: M
authors: Maizels
authors: Elaine
authors: E
authors: Cohen
authors: Rachel Stork
authors: RS
authors: Stoltz
authors: Adeel
authors: A
authors: Jamil
authors: William C
authors: WC
authors: McGaghie
authors: Dana R
authors: DR
authors: Gossett
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D020407:Internet; D007396:Internship and Residency / Q000379:methods*; D009774:Obstetrics / Q000193:education*; D014584:User-Computer Interface