RUB » Bibliotheksportal

Ziad Hilal, Anne-Katrin Kumpernatz, Günther Rezniczek, Cem Cetin, Eva-Katrin Tempfer-Bentz, Clemens Tempfer

• \(\textbf {Background:}\) To compare medical students’ skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration. \(\textbf {Methods:}\) We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later. OSATS scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were secondary outcomes. We assessed the constructive validity of OSATS in this VE model comparing metric scores of experts and students. \(\textbf {Results:}\) In all, 137 students were randomized. OSATS scores were higher in group 2 (n=63) compared with group 1 (n=74) (32.89\(\pm\)6.39 vs 27.51\(\pm\)10.27, respectively; P<0.0001). Global rating scale (1.49\(\pm\)0.76 vs 2.33\(\pm\)0.94, respectively; P<0.0001), confidence (2.22\(\pm\)0.75 vs 3.26\(\pm\)0.94, respectively; P=0.04), self-assessment (2.03\(\pm\)0.62 vs 2.51\(\pm\)0.77, respectively; P<0.0001), and performance time (38.81\(\pm\)11.58seconds vs 47.23\(\pm\)17.35 seconds, respectively; P=0.001) also favored group 2. After 4 days, this effect persisted with OSATS scores still being significantly higher in group 2 (30.00\(\pm\)6.50 vs 25.59\(\pm\)6.09, respectively; P=0.001). The assessed OSATS scores showed constructive validity. In a multiple linear regression analysis, group assignment independently influenced OSATS scores, whereas sex, handedness, sports activities, and type of curriculum were not independently associated with OSATS scores. \(\textbf {Conclusions:}\) Hands-on training is superior to video demonstration for teaching VE on a pelvic model. \(\textbf {Abbreviations:}\) CON = confidence, GRS = global rating scale, OSATS = Objective Structured Assessment of Technical Skills, PT = performance time, SA = self-assessment, VE = vacuum extraction.