Developing Cognitive Task Analysis-based Educational Videos for Basic Surgical Skills in Plastic Surgery.
OBJECTIVE
To describe the development of cognitive task analysis (CTA)-based multimedia educational videos for surgical trainees in plastic surgery.


METHODS
A needs assessment survey was used to identify 5 plastic surgery skills on which to focus the educational videos. Three plastic surgeons were video-recorded performing each skill while describing the procedure, and were interviewed with probing questions. Three medical student reviewers coded transcripts and categorized each step into "action," "decision," or "assessment," and created a cognitive demands table (CDT) for each skill. The CDTs were combined into 1 table that was reviewed by the surgeons performing each skill to ensure accuracy. The final CDTs were compared against each surgeon's original transcripts. The total number of steps identified, percentage of steps shared, and the average percentage of steps omitted were calculated.


METHODS
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, an urban tertiary care teaching center.


METHODS
Canadian junior plastic surgery residents (n = 78) were sent a needs assessment survey. Four plastic surgeons and 1 orthopedic surgeon performed the skills.


RESULTS
Twenty-eight residents responded to the survey (36%). Subcuticular suturing, horizontal and vertical mattress suturing, hand splinting, digital nerve block, and excisional biopsy had the most number of residents (>80%) rank the skills as being skills that students should be able to perform before entering residency. The number of steps identified through CTA ranged from 12 to 29. Percentage of steps shared by all 3 surgeons for each skill ranged from 30% to 48%, while the average percentage of steps that were omitted by each surgeon ranged from 27% to 40%.


CONCLUSIONS
Instructional videos for basic surgical skills may be generated using CTA to help experts provide comprehensive descriptions of a procedure. A CTA-based educational tool may give trainees access to a broader, objective body of knowledge, allowing them to learn decision-making processes before entering the operating room.
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Celine
C
Yeung
Division of Plastic & Reconstructive Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Catherine
C
McMillan
Division of Plastic & Reconstructive Surgery, Toronto Western Hospital, Toronto, Ontario, Canada.
Tomas J
TJ
Saun
Division of Plastic & Reconstructive Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Kimberly
K
Sun
Division of Plastic & Reconstructive Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Veerle
V
D'hondt
Division of Plastic & Reconstructive Surgery, Toronto Western Hospital, Toronto, Ontario, Canada.
Herbert P
HP
von Schroeder
Division of Plastic & Reconstructive Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Glykeria
G
Martou
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Matthew
M
Lee
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Elizabeth
E
Liao
Division of Plastic & Reconstructive Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: p.binhammer@utoronto.ca.
Paul
P
Binhammer
D000046:Academic Medical Centers; D000328:Adult; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D003071:Cognition / Q000502:physiology*; D003479:Curriculum; D020375:Education, Distance / Q000379:methods; D004504:Education, Medical, Undergraduate / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario; D013337:Students, Medical / Q000706:statistics & numerical data; D013518:Surgery, Plastic / Q000193:education*; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D013664:Teaching Materials; D014743:Videotape Recording
Practice-Based Learning and Improvement; basic surgical skills; cognitive task analysis; decision-making skills; e-learning; educational videos; plastic surgery