title: A Randomized Controlled Trial to Compare e-Feedback Versus "Standard" Face-to-Face Verbal Feedback to Improve the Acquisition of Procedural Skill.
abstract: BACKGROUND
  Constructive feedback plays an important role in learning during surgical training. Standard feedback is usually given verbally following direct observation of the procedure by a trained assessor. However, such feedback requires the physical presence of expert faculty members who are usually busy and time-constrained by clinical commitments. We aim to evaluate electronic feedback (e-feedback) after video observation of surgical suturing in comparison with standard face-to-face verbal feedback.
  
  
  METHODS
  A prospective, blinded, randomized controlled trial comparing e-feedback with standard verbal feedback was carried out in February 2015 using a validated pro formas for assessment. The study participants were 38 undergraduate medical students from the University of Sheffield, UK. They were recorded on video performing the procedural skill, completed a self-evaluation form, and received e-feedback on the same day (group 1); observed directly by an assessor, invited to provide verbal self-reflection, and then received standard verbal feedback (group 2). In both groups, the feedback was provided after performing the procedure. The participants returned 2 days later and performed the same skill again. Poststudy questionnaire was used to assess the acceptability of each feedback among the participants.
  
  
  RESULTS
  Overall, 19 students in group 1 and 18 students in group 2 completed the study. Although there was a significant improvement in the overall mean score on the second performance of the task for all participants (first performance mean 11.59, second performance mean 15.95; p ≤ 0.0001), there was no difference in the overall mean improvement score between group 1 and group 2 (4.74 and 3.94, respectively; p = 0.49). The mean overall scores for the e-feedback group at baseline recorded by 2 independent investigators showed good agreement (mean overall scores of 12.84 and 11.89; Cronbach α = 0.86). Poststudy questionnaire demonstrated that both e-feedback and standard verbal feedback achieved high mean Likert grades as recorded by the participants (4.42 [range: 2-5] and 4.71 [range: 4-5], respectively; p = 0.274).
  
  
  CONCLUSIONS
  e-Feedback after watching a video recording appears to be acceptable and is not quantitatively different than standard feedback in improving suturing skills among novice trainees. Video assessment of procedural skills is reliable.
authors.affiliation: Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom. Electronic address: waljundi@hotmail.com.
authors.forename: Wissam
authors.initials: W
authors.lastname: Al-Jundi
authors.affiliation: Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elsharif
authors.affiliation: Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
authors.forename: Melanie
authors.initials: M
authors.lastname: Anderson
authors.affiliation: Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom.
authors.forename: Phillip
authors.initials: P
authors.lastname: Chan
authors.affiliation: Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Beard
authors.affiliation: Sheffield Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Academic Unit of Medical Education, University of Sheffield, Sheffield, United Kingdom.
authors.forename: Shah
authors.initials: S
authors.lastname: Nawaz
mesh_terms: D002983:Clinical Competence; D003142:Communication; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D030141:Feedback, Psychological; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012577:Schools, Medical / Q000458:organization & administration; D016037:Single-Blind Method; D013337:Students, Medical / Q000706:statistics & numerical data; D013536:Suture Techniques / Q000193:education*; D006113:United Kingdom; D014741:Video Recording
keywords: Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Professionalism; e-learning; feedback; procedural skills; surgical training; video recording