The Influence of the Instructional Approach on Acquiring Clinical Skills in Surgery: A Comparative Effectiveness Study

J Surg Educ. 2019 Jan-Feb;76(1):140-149. doi: 10.1016/j.jsurg.2018.07.008. Epub 2018 Aug 16.

Abstract

Objective: The instructional approach used to teach skills and competencies seems to have a critical impact on retaining and performing the learned skills/competencies. However, for most of them, the effect of different instructional approaches as well as evidence for appropriate approaches is unknown. The aim of the present study was to analyze and compare the impact of different instructional approaches in the acquisition of basic skills during undergraduate surgical training.

Design: Randomized controlled cohort study. For the intervention, four instructional approaches ('See one - Do one', 'Video 4-Step Approach', 'Mental Group Mapping', and 'Control') were compared in six basic skills. Students completed a six-station OSCE (one for each skill) during their skills lab training week after the intervention.

Setting: This study was conducted at the medical faculty of the Goethe University, Frankfurt, Germany.

Participants: Medical students in their fourth year completing their four week of obligatory surgical training.

Results: A total of 151 students were included. The group 'Mental Group Mapping' scored significantly higher in comparison to 'See one - Do one' in four of the six skills and 'Control' in five skills. The group 'Video 4-Step Approach' scored significantly higher in comparison to 'See one - Do one' (three skills) in comparison to 'Control' (two skills). There were no significant differences between the approaches 'Mental Group Mapping' and 'Video 4-Step Approach' as well as between the approaches 'See one - Do one' and 'Control'.

Conclusion: Activating instructional approaches such as the '4-Step Approach' and 'Mental Group Mapping' have a significant impact on performing the learned skills and competencies.

Keywords: competencies; instructional approach; practical skills; surgical training; teaching methods; undergraduate medical education.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Clinical Competence*
  • Cohort Studies
  • Education, Medical, Undergraduate / methods*
  • Female
  • Germany
  • Humans
  • Male
  • Specialties, Surgical / education*
  • Young Adult