Asynchronous Unsupervised Video-Enhanced Feedback As Effective As Direct Expert Feedback in the Long-Term Retention of Practical Clinical Skills: Randomised Trial Comparing 2 Feedback Methods in a Cohort of Novice Medical Students

OBJECTIVES: To determine the degree of practical clinical skills' retention over a 7-week period after receiving either video-enhanced direct expert feedback (DEF) or asynchronous unsupervised video-enhanced feedback (UVF). DESIGN: A prospective single-blinded randomized trial was conducted over a 7-week period with novice medical students. Following a generic introduction, Power-Point presentation and live demonstration of intravenous cannulation was given by an expert, and candidates performed the same task in isolation while being recorded and were randomized to receive either DEF or UVF. Further, 20 students were randomized to receive UVF and 22 to receive DEF. Candidates returned to repeat the video-recorded task at week 1, 4, and 7, with no further feedback provision on these occasions. Performances were fully anonymized and independently marked by 2 expert assessors. SETTING: Newcastle University, Medical School, England, United Kingdom. PARTICIPANTS: A total of 42 novice medical students from the preclinical years were selected, with no prior experience of intravenous cannulation. RESULTS: No significant difference existed between demographics of either cohort. Good between-assessor score correlation was noted, with an intraclass correlation coefficient (ICC) of 0.89. The DEF arm significantly improved from their prefeedback performance at Day 1 on repeating the skill a week later (p < 0.0001); this improved score was maintained throughout the duration of the study. The UVF arm showed a nonsignificant improvement; however, there was no significant difference in the scores between the UVF and the DEF groups at any point in the trial. CONCLUSIONS: Video-technology may play a significant role in the provision of feedback for practical skills. The ability for experts to provide remotely delivered but individualized feedback can be an efficient use of valuable resources, while students being able to self-assess their own performance alongside an expert video have the potential to provide students with an excellent opportunity to learn clinical skills without requiring intensive educator involvement. ((C) 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)