title: Multimedia educational tools for cognitive surgical skill acquisition in open and laparoscopic colorectal surgery: a randomized controlled trial.
abstract: OBJECTIVE
  Conventional teaching in surgical training programmes is constrained by time and cost, and has room for improvement. This study aimed to determine the effectiveness of a multimedia educational tool developed for an index colorectal surgical procedure (anterior resection) in teaching and assessment of cognitive skills and to evaluate its acceptability amongst general surgical trainees.
  
  
  METHODS
  Multimedia educational tools in open and laparoscopic anterior resection were developed by filming multiple operations which were edited into procedural steps and substeps and then integrated onto interactive navigational platforms using Adobe® Flash® Professional CS5 10.1. A randomized controlled trial was conducted on general surgical trainees to evaluate the effectiveness of online multimedia in comparison with conventional 'study day' teaching for the acquisition of cognitive skills. All trainees were assessed before and after the study period. Trainees in the multimedia group evaluated the tools by completing a survey.
  
  
  RESULTS
  Fifty-nine trainees were randomized but 27% dropped out, leaving 43 trainees randomized to the multimedia group (n = 25) and study day group (n = 18) who were available for analysis. Posttest scores improved significantly in both groups (P < 0.01). The change in scores (mean ± SD) in the multimedia group was not significantly different from the study day group (6.02 ± 5.12 and 5.31 ± 3.42, respectively; P = 0.61). Twenty-five trainees completed the evaluation survey and experienced an improvement in their decision making (67%) and in factual and anatomical knowledge (88%); 96% agreed that the multimedia tool was a useful additional educational resource.
  
  
  CONCLUSIONS
  Multimedia tools are effective for the acquisition of cognitive skills in colorectal surgery and are well accepted as an educational resource.
authors.affiliation: Academic Unit of Surgical Oncology, Department of Oncology, University of Sheffield, Sheffield, UK; Department of General Surgery, Princess Grace Hospital, London, UK.
authors.forename: U
authors.initials: U
authors.lastname: Shariff
authors.forename: N
authors.initials: N
authors.lastname: Kullar
authors.forename: P N
authors.initials: PN
authors.lastname: Haray
authors.forename: S
authors.initials: S
authors.lastname: Dorudi
authors.forename: S P
authors.initials: SP
authors.lastname: Balasubramanian
mesh_terms: D000328:Adult; D001296:Audiovisual Aids; D002983:Clinical Competence; D003071:Cognition; D003107:Colorectal Surgery / Q000193:education*; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education; D008297:Male; D019212:Multimedia; D013664:Teaching Materials
keywords: Anterior resection; education; multimedia; surgical skills