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Teaching Plastic Surgery Techniques Using Digital Animation Versus a Textbook: A Blinded Prospective Randomized Trial
Roberto L. Flores, MD, Patrick DeMoss, BS, Carrie Klene, DDS, Robert Havlik, MD, Tholpady Sunil, MD PhD.
Indiana University, Indianapolis, IN, USA.
Plastic surgery trainees increasingly use digital animations and simulations to learn operative techniques. The usefulness of these tools in plastic surgery training, however, has not been scientifically tested. We present a blinded, prospective, randomized trial comparing the educational efficacy of digital animation versus textbook in teaching the Ivy Loop technique to novice learners.
Medical student volunteers (n=32) were videotaped as they fastened dental wire to teeth on a skull model (Pre-intervention analysis). Volunteers were then randomly assigned to one of two study groups: Animation (n=16) and Text (n=16). Study groups were shown either a digital animation or textbook demonstrating the Ivy Loop surgical technique. After a 20 minute study session, volunteers were videotaped as they performed the Ivy Loop technique on a skull model (Post-intervention analysis). Volunteers were then shown the educational material provided to the study group to which they were not assigned. The volunteers were asked to appraise the educational value the animation and textbook using the Student Evaluation of Educational Quality (SEEQ) survey, a validated educational quality measurement tool. A score of 1-5 (5 is the highest score) was given across 6 educational metrics for the animation and then the textbook. These metrics were as follows: “The textbook/animation: was stimulating; increased my interest in the subject; allowed me to learn the subject matter; was clear; was an effective way of teaching; was something I would recommend to others”
Pre-intervention and post-intervention video recordings were graded in a blinded fashion by two craniofacial surgeons using a validated surgical competency scale for dental wire handing. Surgical performance grades, time to task completion and educational survey scores were compared.
RESULTS: Pearson’s coefficient analysis revealed low interviewer variability in both the pre-intervention (0.75) and post-intervention analysis (0.92). Pre-intervention surgical performance scores did not significantly differ between the Animation and Text group (10.7 [2.8] vs. 11.1 [3.9]; p=0.74), but post-intervention analysis demonstrated significantly higher performance scores in the Animation group (18.8 [2.9] vs.13.0 [3.5]; p<0.001). Time to task completion was similar. The educational survey demonstrated significantly higher scores in the Animation group across all six metrics.
A blinded, prospective, randomized, study comparing the educational efficacy of a surgical textbook to digital animation demonstrates that, in novice learners, digital animation is a more effective tool to learn the Ivy Loop technique. In addition, test takers found digital animation to be the superior educational medium.
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