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

Abstract

Background: The apprenticeship model of surgical training is the gold standard worldwide. However, increasing evidence shows that its traditional method of teaching surgical procedures covers cognitive skills inadequately. Therefore, the traditional teaching method for surgical procedures may be liable for producing surgeons who are not fully proficient in cognitive decision-making. This study designed a digital teaching method for surgical procedure cognitive skills and compared it to the traditional teaching method. Methods: This was a quantitative experimental study conducted in two phases. Participants were novice medical officers and general surgery residents at the Universities of Botswana and Pretoria. Ethical approval was obtained. The digital teaching method was designed using the ADDIE model and compared to the traditional teaching method. ADDIE is an iterative instructional design model composed of five stages: Analysis, Design, Development, Implementation and Evaluation. A crossover-repeated-measures study design was used to determine the difference in knowledge gain and retention between the two teaching methods. A satisfaction level survey was also conducted. Results: The digital teaching method for surgical procedure cognitive skills was designed and hosted on Moodle. Twenty-nine participants completed the study. The paired sample t-test showed that the mean differenced score for the digital teaching method (M = 3.59, SD = 1.48) was significantly greater than that of the traditional teaching method (M = 1.93, SD = 1.28), t (28) = -10.950, p < 0.001. 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 preferred the digital teaching method over the traditional one. Conclusion: Students taught surgical procedure cognitive skills using the digital teaching method had better knowledge gain and retention than those taught using the traditional teaching method. Participants rated the digital teaching method highly compared to the traditional method. We recommend the adoption of 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.