Investigating the Educational Utility of an Optimized Hand Surgery Video for Carpal Tunnel Release

Currently, there are many resources available for surgical trainees to prepare for surgery. Many of the available resources do not follow procedural learning theory and are not optimized. Thus, we sought to determine if an optimized surgical education video would improve trainee performance of a carpal tunnel release.

We conducted a multicenter, randomized control trial at two institutions. Interns through senior residents were recruited to participate. Participants completed two written descriptions of a carpal tunnel release and two cadaveric carpal tunnel releases: one before access to educational material and one after. Participants were randomized to have access to an optimized surgical technique video versus access to currently available educational resources. Performance was assessed by narrative assessments, the objective structured assessment of technical skills (OSATS) and combined Ottawa Surgical Competency Operating Room Evaluation and P-scores (OP scores). Scores were compared before and after access to educational material with paired t tests and between groups using t tests.

Twenty-five residents participated in the study, with 13 being randomized to the optimized video and 12 to traditional preparation. Participants' baseline narratives, OSATS, and OP scores were similar in both groups. Both groups experienced significant increases in the narrative score (2.8), OSATS score (2.6), O-score (2.5), and P-score (0.4) after having access to educational materials. There were no significant differences in these improvement levels between the two groups.

Access to an educationally optimized surgical technique video did not significantly improve trainee performance in a cadaveric carpal tunnel release model compared with currently available educational resources. Although an educationally optimized video may better meet learners' desires, this does not improve the surgical trainee's performance. Future surgical videos should consider procedural learning theory when being created, but a wholesale recreation of current videos is not needed.

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