Effectiveness of an instructional DVD on third- and fourth-degree laceration repair for obstetrics and gynecology postgraduate trainees☆

Abstract 

Objective

To assess the effectiveness of an instructional DVD on the anatomy and repair of anal sphincter lacerations to improve postgraduate trainees’ understanding.

Methods

A total of 71 obstetrics and gynecology trainees completed a pretest of third- and fourth-degree lacerations to assess baseline knowledge and perceptions. Question categories included anatomy, antibiotics, anesthesia, repair methods, complications, postoperative care, and risk factors. After 1year of clinical experience, 67 trainees (94%) were randomly assigned into DVD (intervention) and non-DVD (control) groups. A post-test was administered 4weeks later.

Results

In the DVD group (n=34), mean scores on the pretest versus the post-test were 65% vs 74% for postgraduate year (PGY)-1 (P=0.09); 72% vs 83% for PGY-2 (P=0.06); 67% vs 83% for PGY-3 (P=0.01); and 75% vs 87% for PGY-4 (P<0.001). In the non-DVD group (n=33), mean scores did not change significantly for any year level. The increase in score from pretest to post-test was significantly different between the 2 groups, independent of year (P<0.001). DVD group scores improved significantly over non-DVD group scores in anatomy (P=0.005) and repair methods (P=0.042) subscales.

Conclusion

An educational video is an effective tool for improving understanding of third- and fourth-degree lacerations for physicians-in-training.

Keywords: Educational DVD, Fourth-degree laceration, Postgraduate trainees, Third-degree laceration, Repair