Nathan Arjun, Fricker Monty, Georgi Maria, Patel Sonam, Hang Man Kien, Asif Aqua, Sinha Amil, Mullins William, Shea Jessie, Hanna Nancy, Monks Massimo, Peprah David, Sharma Akash, Ninkovic-Hall George, Lamb Benjamin W, Kelly John, Sridhar Ashwin, Collins Justin W
Division of Surgery and Interventional Science, University College London, London, United Kingdom.
School of Medicine, Newcastle University, Newcastle, United Kingdom.
J Surg Educ. 2022 May-Jun;79(3):791-801. doi: 10.1016/j.jsurg.2021.11.004. Epub 2021 Nov 29.
This study evaluated the efficacy of virtual classroom training (VCT) in comparison to face-to-face training (FFT) and non-interactive computer-based learning (CBL) for basic surgical skills training.
This was a parallel-group, non-inferiority, prospective randomised controlled trial with three intervention groups conducted in 2021. There were three intervention groups with allocation ratio 1:1:1. Outcome adjudicators were blinded to intervention assignment. Interventions consisted of 90-minute training sessions. VCT was delivered via the BARCO weConnect platform, FFT was provided in-person by expert instructors and CBL was carried out by participants independently. The primary outcome was post-intervention Objective Structured Assessment of Technical Skills score, adjudicated by two experts and adjusted for baseline proficiency. The assessed task was to place three interrupted sutures with hand-tied knots.
This multicentre study recruited from five medical schools in London.
Inclusion criteria were medical student status and access to a personal computer and smartphone. One hundred fifty-nine eligible individuals applied online. Seventy-two participants were randomly selected and stratified by subjective and objective suturing experience prior to permuted block randomization.
Twenty-four participants were allocated to each intervention, all were analysed per-protocol. The sample was 65.3% female with mean age 21.3 (SD 2.1). VCT was non-inferior to FFT (adjusted difference 0.44, 95% CI: -0.54 to 1.75, delta 0.675), VCT was superior to CBL (adjusted difference 1.69, 95% CI: 0.41-2.96) and FFT was superior to CBL (adjusted difference 1.25, 95% CI: 0.20-2.29). The costs per-attendee associated with VCT, FFT and CBL were £22.15, £39.69 and £16.33 respectively. Instructor hours used per student for VCT and FFT were 0.25 and 0.75, respectively.
VCT provides greater accessibility and resource efficiency compared to FFT, with similar educational benefit. VCT has the potential to improve global availability and accessibility of surgical skills training.
本研究评估了虚拟课堂培训（VCT）与面对面培训（FFT）及非交互式基于计算机的学习（CBL）相比，在基础外科技能培训方面的效果。
这是一项于2021年进行的平行组、非劣效性、前瞻性随机对照试验，设有三个干预组。三个干预组的分配比例为1:1:1。结果判定者对干预分配情况不知情。干预措施包括90分钟的培训课程。VCT通过巴可weConnect平台进行，FFT由专家讲师亲自授课，CBL由参与者独立完成。主要结局是干预后的客观结构化技术技能评估得分，由两名专家判定，并根据基线熟练程度进行调整。评估任务是用手打结放置三根间断缝合线。
这项多中心研究从伦敦的五所医学院招募参与者。
纳入标准为医学学生身份以及能够使用个人电脑和智能手机。159名符合条件的个体在线申请。72名参与者被随机选取，并在置换区组随机化之前，根据主观和客观缝合经验进行分层。
每个干预组分配了24名参与者，所有参与者均按方案进行分析。样本中女性占65.3%，平均年龄21.3岁（标准差2.1）。VCT不劣于FFT（调整差异0.44，95%置信区间：-0.54至1.75，δ0.675），VCT优于CBL（调整差异1.69，95%置信区间：0.41 - 2.96），FFT优于CBL（调整差异1.25，95%置信区间：0.20 - 2.29）。与VCT、FFT和CBL相关的每位参与者成本分别为22.15英镑、39.69英镑和16.33英镑。VCT和FFT每位学生使用的教师工时分别为0.25和0.75。
与FFT相比，VCT具有更高的可及性和资源效率，且教育效益相似。VCT有潜力提高外科技能培训的全球可及性和可用性。
