A comparison of surgical procedure cognitive skills acquisition between the traditional apprenticeship and a digital teaching approach

Abstract

Introduction: Mastering the skills required to perform a surgical procedure requires technical and cognitive skills training. However, the traditional method for teaching surgical procedures emphasises technical over cognitive skills acquisition. There is no systematic and sequential approach to teaching surgical procedure cognitive skills. This study aims to design an alternative digital teaching approach for surgical procedure cognitive skills using 3D animated videos and compare it to the traditional teaching method. Methods: A quantitative experimental study consisting of two phases was conducted. Participants were novice medical officers and general surgery residents at the Universities of Botswana, Pretoria, and their affiliated hospitals. We used purposive sampling, and a sample size of 24 was determined. The digital teaching approach was designed using the ADDIE model during Phase I and compared to the traditional model during Phase II. The ADDIE model is an instructional design model comprising five stages: Analysis, Design, Development, Implementation and Evaluation. An instructional design model aims to help educators optimally design and teach the appropriate material. A crossover-repeated-measures study design was used to determine the difference in knowledge gain and retention using pre-, post- and retention tests. Participant satisfaction level and surgical procedure clarity were also compared. Results: The digital teaching method of surgical procedure cognitive skills was designed using the ADDIE model of instructional design. The complete study project, including its evaluation phase, was created and administered via a learning management system (LMS). Twenty-nine (29) participants completed the study. Their mean age was 31.5 years (SD = 3.74). Ten were general surgery residents, and 19 were medical officers in the departments of surgery. All participants were computer literate according to the computer proficiency questionnaire conducted. In the learner needs assessment, all participants agreed that surgical procedure cognitive skills needed to be taught systematically and sequentially. The paired sample t-test showed the mean differenced score for the digital teaching method (M = 3.59, SD = 1.48) to be significantly greater than that of the traditional teaching method (M = 1.93, SD = 1.28), t(28) = -10.950, p < 0.001 (two-tailed). Likewise, the mean differenced retention score for the digital teaching method (M = 2.96, SD = 1.480) was significantly higher than that of the traditional teaching method (M = 1.48, SD = 1.087). Seventy-two percent (18/25) preferred the digital teaching method over the traditional one. In a 12-item questionnaire, all rated the digital teaching method more highly than the traditional one in teaching surgical procedure cognitive skills. Conclusion: Students who were taught surgical procedure cognitive skills using the digital teaching method had greater knowledge gain and retention when compared to those taught using the traditional teaching method. Additionally, participants were more satisfied with the digital than with the traditional approach to teaching surgical procedure cognitive skills. They considered the digital teaching method clearer than the traditional one. The researcher recommends adopting the digital teaching method for teaching surgical procedure cognitive skills to produce surgeons competent in decision-making. The assumption is that this would lead to improved surgical outcomes.