The Effectiveness of a Simulation-Based Flipped Classroom in the Acquisition of Laparoscopic Suturing Skills in Medical Students—A Pilot Study

Publication date: Available online 19 July 2017
Source:Journal of Surgical Education
Author(s): Hsin-Yi Chiu, Yi-No Kang, Wei-Lin Wang, Hung-Chang Huang, Chien-Chih Wu, Wayne Hsu, Yiu-Shun Tong, Po-Li Wei
ObjectiveTo evaluate the effectiveness of a simulation-based flipped classroom in gaining the laparoscopic skills in medical students.DesignAn intervention trial.SettingTaipei Medical University Hospital, an academic teaching hospital.Participants and MethodsFifty-nine medical students participating in a 1-hour laparoscopic skill training session were randomly assigned to a conventional classroom (n = 29) or a flipped classroom approach (n = 30) based on their registered order. At the end of the session, instructors assessed participants' performance in laparoscopic suturing and intracorporeal knot-tying using the assessment checklist based on a modified Objective Structured Assessment of Technical Skills tool.ResultsStudents in the flipped group completed more numbers of stitches (mean [M] = 0.47; standard deviation [SD] = 0.507) than those in the conventional group (M = 0.10; SD = 0.310) (mean difference: 0.37; 95% CI: 0.114-582; p = 0.002). Moreover, students in the flipped group also had higher stitch quality scores (M = 7.17; SD = 2.730) than those in the conventional group (M = 5.14; SD = 1.767) (mean difference = 2.03; 95% CI: 0.83-3.228; p = 0.001). Meanwhile, students in the flipped group had higher pass rates for the second throw (p < 0.001), third throw (p = 0.002), appropriate tissue reapproximation without loosening or strangulation (p < 0.001), needle cut from suture under direct visualization (p = 0.004), and needle safely removed under direct visualization (p = 0.018) than those in the conventional group.ConclusionsComparing with traditional approach, a simulation-based flipped classroom approach may improve laparoscopic intracorporeal knot-tying skill acquisition in medical students.



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