Wed, Nov 11, 2026
[Archive]
Volume 19, Issue 1 (2026)
J Med Edu Dev 2026, 19(1): 12-19 |
Back to browse issues page
Ethics code: 2024/35
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Zengin A, Ulfanov O, Bag Y M, Angin Y S, Ulas M. Effectiveness of video-assisted vs. face-to-face learning in surgical knot-tying skills: a randomized controlled pilot study. , J Med Edu Dev. 2026; 19 (1) :12-19
URL: http://edujournal.zums.ac.ir/article-1-2496-en.html
URL: http://edujournal.zums.ac.ir/article-1-2496-en.html
1- Department of Gastrointestinal Surgery, Eskisehir Osmangazi University, Eskisehir, Turkey , dr.akile.zengin@gmail.com
2- Department of General Surgery, Eskisehir Osmangazi University, Eskisehir, Turkey
3- Department of General Surgery, Ankara Training and Research Hospital, Ankara, Turkey
4- Department of Gastrointestinal Surgery, Eskisehir Osmangazi University, Eskisehir, Turkey
2- Department of General Surgery, Eskisehir Osmangazi University, Eskisehir, Turkey
3- Department of General Surgery, Ankara Training and Research Hospital, Ankara, Turkey
4- Department of Gastrointestinal Surgery, Eskisehir Osmangazi University, Eskisehir, Turkey
Abstract: (1120 Views)
Background & Objective: In contemporary medical education, the shortage of instructors for basic skills training has led to a growing shift toward alternative instructional methods, among which video-based training is a notable approach. This study compared the results of Face-to-Face Learning (FtFL) and Video-Assisted Learning (VAssL) in the acquisition of surgical skills by medical students.
Materials & Methods: Our study was a prospective, single-blinded, randomized controlled pilot trial. 32 medical students were randomly allocated 1:1 to FtFL (n = 16) or VAssL (n = 16) using computer-generated random numbers and sealed opaque envelopes to ensure allocation concealment. The primary outcome was knot-setting success. Secondary outcomes included hand movement proficiency and the number of knots tied per minute. All assessments were performed using a structured scoring table by two blinded assessors.
Results: The mean number of knots tied per minute was 10.97 ± 4.13, and the median knot score was 4 (3–5), with no significant difference between groups (p = 0.476, p = 0.306, respectively). Over 90% of participants succeeded in hand movements, except for knot setting, which had a 65.6% success rate overall. The FtFL group showed significantly higher success in knot setting compared to the VAssL group (93.8% vs. 37.5%, p = 0.002, Cohen’s d = 1.60) and superior hand movement proficiency (median 5 )5–5(vs. 4 )4–5(, p = 0.001).
Conclusion: Face-to-face learning is more beneficial than video-assisted learning for correcting deficiencies and mistakes in medical students' acquisition of surgical skills.
Materials & Methods: Our study was a prospective, single-blinded, randomized controlled pilot trial. 32 medical students were randomly allocated 1:1 to FtFL (n = 16) or VAssL (n = 16) using computer-generated random numbers and sealed opaque envelopes to ensure allocation concealment. The primary outcome was knot-setting success. Secondary outcomes included hand movement proficiency and the number of knots tied per minute. All assessments were performed using a structured scoring table by two blinded assessors.
Results: The mean number of knots tied per minute was 10.97 ± 4.13, and the median knot score was 4 (3–5), with no significant difference between groups (p = 0.476, p = 0.306, respectively). Over 90% of participants succeeded in hand movements, except for knot setting, which had a 65.6% success rate overall. The FtFL group showed significantly higher success in knot setting compared to the VAssL group (93.8% vs. 37.5%, p = 0.002, Cohen’s d = 1.60) and superior hand movement proficiency (median 5 )5–5(vs. 4 )4–5(, p = 0.001).
Conclusion: Face-to-face learning is more beneficial than video-assisted learning for correcting deficiencies and mistakes in medical students' acquisition of surgical skills.
Keywords: surgical education, knot-tying, face-to-face learning, video-assisted learning, medical students, psychomotor skills
Editorial: Original Research |
Subject:
Medical Education
Received: 2025/06/4 | Accepted: 2025/11/29 | Published: 2026/01/1
Received: 2025/06/4 | Accepted: 2025/11/29 | Published: 2026/01/1
References
1. Shahrezaei A, Sohani M, Taherkhani S, Zarghami SY. The impact of surgical simulation and training technologies on general surgery education. BMC Med Educ. 2024;24(1):1-15. [DOI:10.1186/s12909-024-05534-8] [PMID] [PMCID]
2. Imran M. Clinical skills learning of the first-year medical students at clinical skills laboratory using simulated patients. Rev Esp Educ Médica. 2025;6(2):1-11.
https://doi.org/10.6018/edumed.646921 [DOI:10.6018/edumed.632541]
3. Rothman D. Suture selection and knot tying demonstration. J Med Insight. 2024;2024(478). Available from: https://jomi.com/article/478/suture-selection-and-knot-tying-demonstration [DOI:10.24296/jomi/478]
4. Chang Y, Yu D, Wang L, Zhang J, Yan M, Li H, et al. A novel and efficient surgical knotting technique for high-tension closures. Ann Transl Med. 2021;9(5):1-6. [DOI:10.21037/atm-20-8033] [PMID] [PMCID]
5. Wu V, Yeung C, Sykes EA, Zevin B. Comparison of knot-tying proficiency and knot characteristics for square and reversing half hitch alternating-post surgical knots in a simulated deep body cavity among novice medical students. Can J Surg. 2018;61(6):385-391. [DOI:10.1503/cjs.012617] [PMID] [PMCID]
6. Shen J, Zhang S, Sun D, Ge R, Chen S, Fang J, et al. Comparison of face-to-face teaching and online teaching in neurosurgery education for medical students. BMC Med Educ. 2025;25(1):1-9.
https://doi.org/10.1186/s12909-025-06817-4 [DOI:10.1186/s12909-025-06143-1] [PMID] [PMCID]
7. Kumins NH, Qin VL, Driscoll EC, Morrow KL, Kashyap VS, Ning AY, et al. Computer-based video training is effective in teaching basic surgical skills to novices without faculty involvement using a self-directed, sequential and incremental program. Am J Surg. 2021;221(4):780-787. [DOI:10.1016/j.amjsurg.2020.07.018] [PMID]
8. Mao BP, Teichroeb ML, Lee T, Wong G, Pang T, Pleass H. Is online video-based education an effective method to teach basic surgical skills to students and surgical trainees? A systematic review and meta-analysis. J Surg Educ. 2022;79(6):1536-1545. [DOI:10.1016/j.jsurg.2022.07.004] [PMID]
9. Lwin AT, Lwin T, Naing P, Oo Y, Kidd D, Cerullo M, et al. Self-directed interactive video-based instruction versus instructor-led teaching for Myanmar house surgeons: a randomized, noninferiority trial. J Surg Educ. 2018;75(1):238-246. [DOI:10.1016/j.jsurg.2017.06.027] [PMID]
10. Sun R. Comparative study of online learning and face-to-face learning. InSHS Web of Conferences 2023 (Vol. 180, p. 04006). EDP Sciences; 2023:1-5. [DOI:10.1051/shsconf/202318004006]
11. Tejos R, Crovari F, Achurra P, Avila R, Inzunza M, Jarry C, et al. Video based guided simulation without peer or expert feedback is not enough: a randomized controlled trial of simulation based training for medical students. World J Surg. 2021;45(1):57-65. [DOI:10.1007/s00268-020-05750-5] [PMID] [PMCID]
12. Forde C, O'Brien A, Croitoru O, Molloy N, Amisano C, Brennan I, et al. Comparing face-to-face, blended and online teaching approaches for practical skill acquisition: a randomised controlled trial. Med Sci Educ. 2024;34(3):627-637. [DOI:10.1007/s40670-024-02082-0] [PMID] [PMCID]
13. Bochenska K, Milad MP, DeLancey JO, Lewicky-Gaupp C. Instructional video and medical student surgical knot-tying proficiency: randomized controlled trial. JMIR Med Educ. 2018;4(1):e9068. [DOI:10.2196/mededu.9068] [PMID] [PMCID]
14. Cooper JB, Taqueti V. A brief history of the development of mannequin simulators for clinical education and training. Postgrad Med J. 2008;84(997):563-570. [DOI:10.1136/qshc.2004.009886] [PMID]
15. Purkarthofer E, Mäntysalo R. Enhancing knowledge, skills, and identity development through collaborative student-led learning: experiences with the gradual empowerment of students in a planning studio course. J Plan Educ Res. 2024;44(3):1148-1159.
https://doi.org/10.1177/0739456X221118599 [DOI:10.1177/0739456X231220710]
16. Seo HS, Eom YH, Kim MK, Kim YM, Song BJ, Song KY. A one-day surgical-skill training course for medical students' improved surgical skills and increased interest in surgery as a career. BMC Med Educ. 2017;17:265. [DOI:10.1186/s12909-017-1104-z] [PMID] [PMCID]
17. Roberts KE, Bell RL, Duffy AJ. Evolution of surgical skills training. World J Gastroenterol. 2006;12(20):3219-3224. [DOI:10.3748/wjg.v12.i20.3219] [PMID] [PMCID]
18. Al-Kadi AS, Donnon T. Using simulation to improve the cognitive and psychomotor skills of novice students in advanced laparoscopic surgery: a meta-analysis. Med Teach. 2013;35(sup1):S47-S55. [DOI:10.3109/0142159X.2013.765546] [PMID]
19. Satava RM. Historical review of surgical simulation-a personal perspective. World J Surg. 2008;32(2):141-148. [DOI:10.1007/s00268-007-9374-y] [PMID]
20. Sørensen TS, Greil GF, Hansen OK, Mosegaard J. Surgical simulation--a new tool to evaluate surgical incisions in congenital heart disease? Interact Cardiovasc Thorac Surg. 2006;5(5):536-539. [DOI:10.1510/icvts.2006.132316] [PMID]
21. Muehlberg J, Tipold A, Heppelmann M, Wissing S. Simulator-assisted training of abomasal surgery-a pilot study using blended learning and face-to-face teaching. Animals. 2023;13(24):1-19. [DOI:10.3390/ani13243829] [PMID] [PMCID]
22. Raythatha J, Hameed A, Lee T, Yuen L, Nahm CB, Pang T, et al. Technical skills teaching to MD students: a blinded, randomized controlled trial investigating video assistance in the education of the single-handed knot tie. Discov Educ. 2024;3(1):1-8. [DOI:10.1007/s44217-024-00118-6]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
