Standardized Patient vs Video Demonstration for Teaching Psychomotor Skills in Spinal Injury Management to...

Emergency trauma care in the "golden hour" can reduce the fatality rates by 20%-50%. Imparting trauma care training in the undergraduate Indian medical graduate curriculum can prepare graduates as first responders for both prehospital and hospital setup management. However, teaching these skills for managing acute traumas in a competency-based medical education curriculum is challenging. These skills can be taught on a standardized patient (SP), allowing the learner to achieve higher clinical competency and better communication skills. However, since SP availability is limited, a video demonstration (VD) of such skills is an easy and reliable teaching-learning method.

This study aims to evaluate the effectiveness of using an SP vs VD for teaching psychomotor skills to undergraduate students in the management of spinal injury.

A prospective interventional comparative study was performed in the orthopedics department of a teaching hospital from September 2024 to February 2025, with institutional ethics committee approval. Thirty undergraduate students posted in the orthopedics department were divided into 2 groups (15 each) based on their even and odd roll numbers (systematic sampling). One group was shown a VD of the skills like application of an improvised cervical collar and log rolling maneuver for the management of a patient with spinal injury in a primary setting, while the other group was taught on an SP. The students were assessed by an objective structured clinical examination (OSCE), and maneuvers were performed on mannequins. Pretest and posttest evaluations with peer-validated questionnaires along with students' feedbacks were obtained. The data were analyzed using unpaired 2-sided t test for OSCE scores and paired 2-sided t test for pretest and posttest scores with statistical significance set at P<.05 (95% CI). Student feedback questionnaires based on a 5-point Likert scale were evaluated.

The mean OSCE scores obtained by the VD group (15.47) were significantly different from those obtained by the SP group (18.27) (P=.004). However, the mean OSCE scores obtained in individual skill demonstration stations for log rolling maneuver and cervical spine immobilization of the VD group were 2.27 and 3.20 and those of the SP group were 2.33 and 3.27, respectively. This difference was not significant (P=.74 and .79, respectively). The student feedback showed that teaching with an SP was marginally more interesting and effective, giving them more confidence to apply these skills in a primary setting.

Both VD and SP methods are equally effective for teaching lifesaving psychomotor skills for the management of spinal injury. However, SP group students had better student engagement. Hence, a blended approach, where VD is used to teach large groups or can be given to students prior to the sessions, followed by teaching or assessing on SPs for application of these skills will lead to optimum results and save time.