Use of mobile learning module improves skills in chest tube insertion

Background: Just-In-Time Learning is a concept increasingly applied to medical education, and its efficacy must be evaluated. Materials and methods: A 3-minute video on chest tube insertion was produced. Consenting participants were assigned to either the video group, which viewed the video on an Apple (R) iPod Touch immediately before chest tube insertion, or the control group, which received no instruction. Every participant filled out a questionnaire regarding prior chest tube experience. A trained clinician observed participants insert a chest tube on the TraumaMan (R) task simulator, and assessed performance using a 14-item skills checklist. Results: Overall, 128 healthcare trainees participated, with 50% in the video group. Participants included residents (34.4%, n = 44), medical students (32.8%, n = 42), and U.S. Army Forward Surgical Team members (32.8%, n = 42). Sixty-nine percent of all participants responded that they had never placed a chest tube, but 7% had placed more than 20. Only 25% of the participants had previously used TraumaMan (R). Subjects who viewed the video scored better on the skills checklist than the control group (11.09 +/- 3.09 versus 7.17 +/- 3.56, P < 0.001, Cohen's D - 1.16). Medical students (9.33 +/- 2.65 versus 4.52 +/- 3.64, P < 0.001), Forward Surgical Team members (10.07 +/- 2.52 versus 8.57 +/- 3.22, P < 0.001), anesthesia residents (8.25 +/- 2.56 versus 5.9 +/- 2.23, P = 0.017), and subjects who had placed fewer than 10 chest tubes (9.7 +/- 3 versus 6.6 +/- 3.9, P < 0.001) performed significantly better with the video. Conclusions: The procedural animation video is an effective medium for teaching procedural skills. Embedding the video on a mobile device, and allowing trainees to access it immediately before chest tube insertion, may enhance and standardize surgical education for civilians and military personnel. (C) 2012 Elsevier Inc. All rights reserved.