A Comparison of Guided Video Reflection versus Self-Regulated Learning to Teach Knot Tying to Medical Students: A Pilot Randomized Controlled Trial

Peter Zhan Tao Wang; Wen Yan Xie; Shiva Nair; Sumit Dave; John Shatzer; Saad Chahine

doi:10.1016/j.jsurg.2020.02.014

A Comparison of Guided Video Reflection versus Self-Regulated Learning to Teach Knot Tying to Medical Students: A Pilot Randomized Controlled Trial

J Surg Educ. 2020 Jul-Aug;77(4):805-816. doi: 10.1016/j.jsurg.2020.02.014. Epub 2020 Mar 6.

Authors

Peter Zhan Tao Wang¹, Wen Yan Xie², Shiva Nair², Sumit Dave², John Shatzer³, Saad Chahine⁴

Affiliations

¹ Department of Surgery, Division of Urology, Western University, London, Ontario, Canada. Electronic address: peter.wang@lhsc.on.ca.
² Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.
³ John Hopkins University, School of Education, Baltimore, Maryland.
⁴ Faculty of Education, Queen's University, Kingston, Ontario, Canada.

PMID: 32151512
DOI: 10.1016/j.jsurg.2020.02.014

Abstract

Objectives: Self-regulated learning has been proposed as a resource saving alternative for learning knot tying. However, this may be hindered by the Dunning-Kruger effect. A potential alternative is guided video reflection. The objectives of this study are to compare the performance and self-assessment abilities amongst medical students learning knot tying using either a traditional self-regulated approach versus guided video reflection.

Design: This randomized, single-blinded, controlled trial used a pre-post-retention test design. All knot tying performances were video recorded and assessed nonsequentially by blinded evaluators using a modified Objective Structured Assessment of Technical Skills tool.

Participants: This study recruited 31 first- and second-year medical students and 6 senior urology residents from Western University in Canada.

Results: At baseline, the performances of the experts were significantly higher than the experimental groups (F_3,85 = 9.080, p < 0.001). After the intervention, there was a significant increase in the performance for both experimental groups compared to the pretest period (p < 0.001). The scores between the experimental groups were not significantly different (p = 0.338). The improved performances of both groups were sustained on retention testing (p < 0.001). The self-assessment abilities were accurate for both experimental groups at baseline. However, at the post-test period the accuracy was poor (interclass correlation 0.361) for the self-regulated group, while remaining moderately (interclass correlation 0.685) accurate for the reflection group.

Conclusions: Students using guided video reflection were able to achieve competency and maintained their knot tying skills to the same degree as those who used the self-regulated approach. These results may be due to the positive effects of reflection on self-assessment abilities and subsequent improvement in goal setting for further practice.

Keywords: Medical Knowledge; guided; knot tying; reflection; reflective practice; self-regulated; video.

Publication types

Randomized Controlled Trial

MeSH terms

Canada
Clinical Competence
Humans
Pilot Projects
Students, Medical*
Suture Techniques