Abstract
Aim Several motor learning models have been used to teach highly complex procedural skills
in medical education. The aim of this randomized controlled trial was to assess the
efficiency of telementoring of open and laparoscopic suturing of medical students
compared to conventional in-person teaching and training.
Methods After randomization, 23 medical students were assigned to either the telementoring
or the in-person training group. Both groups were taught by surgically trained residence
with a student–teacher ratio of 1:1 (teacher–student). Open suturing was assessed
in a model of congenital diaphragmatic hernia and laparoscopic suturing in a model
of bowel anastomosis. All subjects were trained according to the spaced learning concept
for 3 hours. Primary end points were time, knot quality, precision, knot strength,
and overall knotting performance/competency. Furthermore, we utilized the Surgery
Task Load Index to evaluate the cognitive load of both teaching techniques. Students'
subjective progress regarding skill acquisitions and acceptance of telementoring was
assessed using a nine-item questionnaire.
Results All 23 trainees significantly improved after training in all knot attributes. More
than 90% of all subjects reached proficiency in both groups. In-person training and
telementoring were similarly practical, and no significant differences regarding speed,
knot quality, precision, knot stability, and procedure performance/competency were
found. Students perceived no difference in acquisition of factual or applicational
knowledge between the two groups. General acceptance of telementoring was moderate
in both groups before training, but increased during training in students actually
assigned to this group, in comparison to students assigned to conventional teaching.
Conclusion The current study shows that telementoring of open and laparoscopic suturing is an
ideal answer to the current coronavirus disease 2019 pandemic, ensuring continuous
training. On-site training and telementoring are similarly effective, leading to substantial
improvement in proficiency in intracorporeal suturing and knot tying. Likewise, students'
subjective progress regarding skill acquisitions and cognitive load does not differ
between teaching methods. Skepticism toward telementoring decreases after exposure
to this learning method. Given our results, telementoring should be considered a highly
effective and resource-saving educational approach even after the current pandemic.
Keywords
spaced learning - laparoscopy - suturing - surgery - training
