Assessment of Surgical Training Modality Efficacy in Medical Students – A Comparison of Surgical Simulation, Video Demonstration, and Live Instruction

Surgical simulation is a growing form of education in medical training, but it remains unclear how simulation compares to traditional lecture or apprenticeship models of teaching when translating procedural knowledge to surgical performance. This study aimed to assess the effectiveness of translating procedural knowledge to surgical skill when trained by the surgical simulation app “Touch Surgery (TS),” recorded video lecture, or in-person teaching of the trigger finger release (TFR) surgery. The study also aimed to identify the learners’ preferred teaching modality. Twenty-seven first- and second-year medical students were recruited to participate. They were randomly assigned to one of three cohorts (n=9) as designated by a different TFR surgery learning modality: surgical simulation through TS (cohort “SS”), video demonstration (cohort “VIDEO”), or live teaching by a board-certified orthopaedic hand surgeon (cohort “LIVE”). Each participant completed their modality three times. They then completed an assessment of the procedural steps before performing the TFR surgery on a cadaver. Outcome measures included procedural test scores and cadaveric performance, evaluated using a surgery-specific detailed checklist, a global rating scale (GRS) of soft surgical skills, and a pass/fail assessment. Participants graded their modality’s usefulness using a 5-point Likert scale. There was no statistically significant difference in TFR procedural assessment scores (P=0.123) or cadaveric surgical performance between groups when evaluated by the surgery-specific step checklist (P=0.549), GRS (P=0.567), and pass/fail assessment (P=0.874). Students in the LIVE cohort rated their modality as their first-choice training tool (P=0.009); however, those in the SS cohort rated their modality as easiest to use, follow, and understand (P=0.010). All educational modalities should be considered in surgical training. This study demonstrates that students can perform cognitively and technically similar learning from virtual or live formats; however, they preferred live teaching. III