Technical skills teaching to MD students: a blinded, randomized controlled trial investigating video assistance in the education of the single-handed knot tie

Abstract

Background: The COVID-19 pandemic has brought significant changes to medical education, particularly for procedural and surgical skills, which inherently require face-to-face education. The utility of adding an instructional video remains uncertain. To guide future curricula, our aim was to assess whether the addition of an optional instructional video improves the acquisition and retention of one-handed surgical knot-tying. Methods: Naïve year one medical students were randomised to video before face-to-face instruction versus face-to-face instruction only. Blinded surgeons assessed their performance at the end of a workshop and 4 weeks later by counting the number of knots tied in 1 min and a global Likert score assessing knot quality. The students also completed surveys for qualitative assessment and feedback. Results: Students with access to the video tied significantly more knots in 1 min than the control group (median ± IQR: 15 ± 4 N = 14, vs 12.5 ± 10 N = 15, p = 0.012). After 4 weeks, the intervention group showed a non-significant trend towards being able to tie more knots (16.5 ± 6 N = 6, vs 3.5 ± 16 N = 8, p = 0.069), and the knots tied were of significantly better quality (global score: 3 ± 1.4 vs 1 ± 1.8, p = 0.027). Compared to the control group, the intervention group expressed greater confidence in their ability to retain their skills after the workshop and at follow-up (p = 0.04). Additionally, they experienced significantly less stress during the workshop (p = 0.028). Conclusion: A non-interactive video can improve learning and retention of single-handed knot tying. As medical education continues to evolve, supplementary videos should be considered an important part of new surgical skill curricula.