Departments of Obstetrics, Gynecology, and Reproductive Sciences, and Anesthesia, University of California, San Francisco, San Francisco, California, and the Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University, Kampala, Uganda.
Obstet Gynecol. 2013 Jul;122(1):127-131. doi: 10.1097/AOG.0b013e3182964b8c.
To study the feasibility and acceptability of using video Internet communication to teach and evaluate surgical skills in a low-resource setting.
This case-controlled study used video Internet communication for surgical skills teaching and evaluation. We randomized intern physicians rotating in the Obstetrics and Gynecology Department at Mulago Hospital at Makerere University in Kampala, Uganda, to the control arm (usual practice) or intervention arm (three video teaching sessions with University of California, San Francisco faculty). We made preintervention and postintervention videos of all interns tying knots using a small video camera and uploaded the files to a file hosting service that offers cloud storage. A blinded faculty member graded all of the videos. Both groups completed a survey at the end of the study.
We randomized 18 interns with complete data for eight in the intervention group and seven in the control group. We found score improvement of 50% or more in six of eight (75%) interns in the intervention group compared with one of seven (14%) in the control group (P=.04). Scores declined in five of the seven (71%) controls but in none in the intervention group. Both intervention and control groups used attendings, colleagues, and the Internet as sources for learning about knot-tying. The control group was less likely to practice knot-tying than the intervention group. The trainees and the instructors felt this method of training was enjoyable and helpful.
Remote teaching in low-resource settings, where faculty time is limited and access to visiting faculty is sporadic, is feasible, effective, and well-accepted by both learner and teacher.
II.
研究在资源匮乏的环境中使用视频互联网通讯进行外科技能教学和评估的可行性和可接受性。
本病例对照研究使用视频互联网通讯进行外科技能教学和评估。我们将在乌干达坎帕拉的穆拉戈医院妇产科轮转的实习医生随机分配到对照组（常规做法）或干预组（与旧金山加利福尼亚大学的教员进行三次视频教学课程）。我们使用小型摄像机对所有实习医生进行系结操作的预干预和后干预视频拍摄，并将文件上传到提供云存储的文件托管服务。一位盲法教员对所有视频进行评分。两组在研究结束时都完成了一项调查。
我们随机分配了 18 名有完整数据的实习医生，其中 8 名在干预组，7 名在对照组。我们发现，与对照组中 7 名中的 1 名（14%）相比，干预组中 8 名中的 6 名（75%）的得分提高了 50%或更多。对照组中有 7 名中的 5 名（71%）的得分下降，但干预组中没有。干预组和对照组都将主治医生、同事和互联网作为学习打结的来源。对照组比干预组更不可能练习打结。学员和指导员都觉得这种培训方法很有趣和有帮助。
在资源有限且访问客座教员机会有限的低资源环境中，远程教学是可行、有效且受到学习者和教师双方欢迎的。
II 级。
