Videotape versus live demonstration in enhancing the technique and confidence of direct ophthalmoscopy in undergraduate medical education: A randomized controlled trial in a South Asian medical school

Abstract

Introduction and Objectives: Ophthalmoscopy is a core clinical skill. Our objective was to evaluate the effectiveness of a videotape, a live demonstration and a combination of above, in acquiring competence in Direct Ophthalmoscopy (DO) among medical undergraduates. Materials and Methods: A randomized controlled trial was conducted among pre clinical medical students of University of Colombo. Students were randomly allocated to three groups. Group-V and Group-L were trained on DO for 20 minutes using a videotape and by a live demonstration respectively. A third group (Group-VL) was trained with both methods for a total of 20 minutes. Videotapes were obtained while students performed DO on a simulated patient. Three blinded examiners assessed the recordings individually using the modified Queens University Ophthalmoscopy OSCE checklist. Learning styles were assessed using the VARK questionnaire. Results: A total of 106 students [37.7% (n=40) males] were assessed. The mean score of DO was (10.0±2.5)/14. Majority were multimodal learners (61.3%, n=65). A two-way ANOVA showed a statistically significant effect of teaching method on performance score of DO [F(2,86)=7.024, p=.001, partial η2 =.140). Post-hoc comparisons indicated that mean scores for each group were significantly different: Group-V (M=8.27, SD=2.07); Group-L (M=10.15,SD=2.32) and Group-VL (M=11.71, SD=1.47), p<.001. The interaction effect for learning styles, F(4,86)=0.398, p=.810, did not reach a statistically significant level. Conclusions: The live demonstration showed a better result than the video tape demonstration (p<.05). The combination of video tape and live demonstration was significantly better than the other two methods (p<.05). Their performance was not affected by learning styles. We recommend a combined approach as the preferred method of teaching DO to medical undergraduates irrespective of their learning styles