Improving Medical Interns’ Levels of Clinical Skills Competence and Self-Confidence Levels via Video IPods: a Pilot Randomized Controlled Trial
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Abstract
Background
Today’s health-care educators need to be mindful of instructional design and execute effective and powerful tools to provide evidence-based education. The use of Social Web (Web 2.0) applications is evolving as learning tools in healthcare professional development and education. However, there is a paucity of empirical research to support the effectiveness of interactive Web 2.0 applications on medical education outcomes.
Objectives
The goal of this study was to determine if clinical instructional videos, pertaining to female and male urinary catheter insertion, delivered via Apple Computer iPods would increase medical students’ confidence levels and enhance skill competencies.
Methods
A prospective study was conducted with medical trainee intern (TI) participants: 10 control participants (without any technological intervention) and 11 intervention participants (two clinical videos delivered via Apple Computer video iPods). A questionnaire regarding previous exposure to male and female urinary catheterisation and their level of confidence in performing the skills was completed before participating in a required skills course at the Advanced Clinical Skills Center (ACSC) laboratory at the University of Auckland, New Zealand. Directly following the completion of the questionnaire, medical faculty gave a 40-minute skills demonstration in the ACSC. Both groups received verbal instruction in the catheterisation procedure, a demonstration by a clinical tutor, a copy of the 'marking' proforma outlining the steps in the procedure and were then able to practice the procedure once whilst supervised before being tested. It is possible both groups would have as students seen these procedures on the wards and may have had the opportunity to perform this procedure prior to the clinical skills course where this was taught. Participants completed a post-course questionnaire regarding skill confidence levels following the clinical-skill evaluation in the ACSC. The intervention group received an iPod with only the male and female catheterisation procedure videos and were able to watch the two videos an unlimited number of times in the 3-month period before follow-up. The control group did not have access to the videos via the iPod, online, or on a computer during the 3-month time frame and the intervention group was asked not to share the iPod videos with members from the control group. Both groups were on the same clinical rotation over the 3 month period. All participants completed a follow-up questionnaire and a clinical assessment of urinary catheterisation skills at the ACSC lab directly following the 3-month period.
Results
The results illustrate skill competency weakening over time among the control group for both male and female catheterizations; however, the competency level was stable among the experimental group for both procedures. Interaction results for competency scores indicate a significant level by group and time (P= .03) and procedure and group (P= .02). The experimental group’s confidence level for performing the female catheterization procedure differed significantly over time (P< .001). Moreover, confidence scores in performing female catheterizations increased for both groups over time. Interestingly, both groups’ confidence levels for performing the male catheterization decreased over time.
Conclusions
Interactive Web 2.0 tools offer a new andragogical approach to improve medical students’ self-confidence levels and skills acquisitions. Further empirical research is needed in order to generalize to the medical school population at the global level.
Today’s health-care educators need to be mindful of instructional design and execute effective and powerful tools to provide evidence-based education. The use of Social Web (Web 2.0) applications is evolving as learning tools in healthcare professional development and education. However, there is a paucity of empirical research to support the effectiveness of interactive Web 2.0 applications on medical education outcomes.
Objectives
The goal of this study was to determine if clinical instructional videos, pertaining to female and male urinary catheter insertion, delivered via Apple Computer iPods would increase medical students’ confidence levels and enhance skill competencies.
Methods
A prospective study was conducted with medical trainee intern (TI) participants: 10 control participants (without any technological intervention) and 11 intervention participants (two clinical videos delivered via Apple Computer video iPods). A questionnaire regarding previous exposure to male and female urinary catheterisation and their level of confidence in performing the skills was completed before participating in a required skills course at the Advanced Clinical Skills Center (ACSC) laboratory at the University of Auckland, New Zealand. Directly following the completion of the questionnaire, medical faculty gave a 40-minute skills demonstration in the ACSC. Both groups received verbal instruction in the catheterisation procedure, a demonstration by a clinical tutor, a copy of the 'marking' proforma outlining the steps in the procedure and were then able to practice the procedure once whilst supervised before being tested. It is possible both groups would have as students seen these procedures on the wards and may have had the opportunity to perform this procedure prior to the clinical skills course where this was taught. Participants completed a post-course questionnaire regarding skill confidence levels following the clinical-skill evaluation in the ACSC. The intervention group received an iPod with only the male and female catheterisation procedure videos and were able to watch the two videos an unlimited number of times in the 3-month period before follow-up. The control group did not have access to the videos via the iPod, online, or on a computer during the 3-month time frame and the intervention group was asked not to share the iPod videos with members from the control group. Both groups were on the same clinical rotation over the 3 month period. All participants completed a follow-up questionnaire and a clinical assessment of urinary catheterisation skills at the ACSC lab directly following the 3-month period.
Results
The results illustrate skill competency weakening over time among the control group for both male and female catheterizations; however, the competency level was stable among the experimental group for both procedures. Interaction results for competency scores indicate a significant level by group and time (P= .03) and procedure and group (P= .02). The experimental group’s confidence level for performing the female catheterization procedure differed significantly over time (P< .001). Moreover, confidence scores in performing female catheterizations increased for both groups over time. Interestingly, both groups’ confidence levels for performing the male catheterization decreased over time.
Conclusions
Interactive Web 2.0 tools offer a new andragogical approach to improve medical students’ self-confidence levels and skills acquisitions. Further empirical research is needed in order to generalize to the medical school population at the global level.
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