title: A randomized comparison of video demonstration versus hands-on training of medical students for vacuum delivery using Objective Structured Assessment of Technical Skills (OSATS).
abstract: BACKGROUND
  To compare medical students' skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration.
  
  
  METHODS
  We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later. OSATS scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were secondary outcomes. We assessed the constructive validity of OSATS in this VE model comparing metric scores of experts and students.
  
  
  RESULTS
  In all, 137 students were randomized. OSATS scores were higher in group 2 (n = 63) compared with group 1 (n = 74) (32.89 ± 6.39 vs 27.51 ± 10.27, respectively; P < 0.0001). Global rating scale (1.49 ± 0.76 vs 2.33 ± 0.94, respectively; P < 0.0001), confidence (2.22 ± 0.75 vs 3.26 ± 0.94, respectively; P = 0.04), self-assessment (2.03 ± 0.62 vs 2.51 ± 0.77, respectively; P < 0.0001), and performance time (38.81 ± 11.58 seconds vs 47.23 ± 17.35 seconds, respectively; P = 0.001) also favored group 2. After 4 days, this effect persisted with OSATS scores still being significantly higher in group 2 (30.00 ± 6.50 vs 25.59 ± 6.09, respectively; P = 0.001). The assessed OSATS scores showed constructive validity. In a multiple linear regression analysis, group assignment independently influenced OSATS scores, whereas sex, handedness, sports activities, and type of curriculum were not independently associated with OSATS scores.
  
  
  CONCLUSIONS
  Hands-on training is superior to video demonstration for teaching VE on a pelvic model.
authors.affiliation: Department of Obstetrics and Gynecology, Ruhr Universität Bochum, Bochum, Germany.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Hilal
authors.forename: Anne K
authors.initials: AK
authors.lastname: Kumpernatz
authors.forename: Günther A
authors.initials: GA
authors.lastname: Rezniczek
authors.forename: Cem
authors.initials: C
authors.lastname: Cetin
authors.forename: Eva-Katrin
authors.initials: EK
authors.lastname: Tempfer-Bentz
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
mesh_terms: D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000193:education* / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D008953:Models, Anatomic; D020377:Self Efficacy; D012647:Self-Assessment; D016037:Single-Blind Method; D014618:Vacuum; D014743:Videotape Recording