title: Individualised Expert Feedback is Not Essential for Improving Basic Clinical Skills Performance in Novice Learners: A Randomized Trial.
abstract: OBJECTIVE
  To determine whether unsupervised video feedback (UVF) is as effective as direct expert feedback (DEF) in improving clinical skills performance for medical students learning basic surgical skills-intravenous cannulation, catheterization, and suturing.
  
  
  BACKGROUND
  Feedback is a vital component of the learning process, yet great variation persists in its quality, quantity, and methods of delivery. The use of video technology to assist in the provision of feedback has been adopted increasingly.
  
  
  METHODS
  A prospective, blinded randomized trial comparing DEF, an expert reviewing students' performances with subsequent improvement suggestions, and UVF, students reviewing their own performance with an expert teaching video, was carried out. Medical students received an initial teaching lecture on intravenous cannulation, catheterization, and suturing and were then recorded performing the task. They subsequently received either DEF or UVF before reperforming the task. Students' recordings were additionally scored by 2 blinded experts using a validated proforma.
  
  
  RESULTS
  A total of 71 medical students were recruited. Cannulation scores improved 4.3% with DEF and 9.5% with UVF (p = 0.044), catheterization scores improved 8.7% with DEF and 8.9% with UVF (p = 0.96), and suturing improved 15.6% with DEF and 13.2% with UVF (p = 0.54). Improvement from baseline scores was significant in all cases (p < 0.05).
  
  
  CONCLUSIONS
  Video-assisted feedback allows a significant improvement in clinical skills for novices. No significant additional benefit was demonstrated from DEF, and a similar improvement can be obtained using a generic expert video and allowing students to review their own performance. This could have significant implications for the design and delivery of such training.
authors.affiliation: Northern Oesophagogastric Cancer Unit, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom. Electronic address: awphillips@doctors.net.uk.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Phillips
authors.affiliation: Anatomy and Clinical Skills Department, School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Joanna
authors.initials: J
authors.lastname: Matthan
authors.affiliation: Department of General Surgery, James Cook University Hospital, Middlesbrough, United Kingdom.
authors.forename: Lucy R
authors.initials: LR
authors.lastname: Bookless
authors.affiliation: Department of General Surgery, St Helen's and Knowsley Hospitals NHS Trust, St Helens, United Kingdom.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Whitehead
authors.affiliation: Northern Oesophagogastric Cancer Unit, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
authors.forename: Anantha
authors.initials: A
authors.lastname: Madhavan
authors.affiliation: Royal Victoria Infirmary, The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Rodham
authors.affiliation: Royal Victoria Infirmary, The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
authors.forename: Anna L R
authors.initials: ALR
authors.lastname: Porter
authors.affiliation: Department of Vascular Surgery, James Cook University Hospital, Middlesbrough, United Kingdom.
authors.forename: Craig I
authors.initials: CI
authors.lastname: Nesbitt
authors.affiliation: Department of Vascular Surgery, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
authors.forename: Gerard
authors.initials: G
authors.lastname: Stansby
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013536:Suture Techniques / Q000193:education*; D014741:Video Recording
keywords: Practice-Based Learning and Improvement; clinical skills; feedback; practical clinical skills; simulation; technology-enhanced learning; video technology