Development and evaluation of cesarean section surgical training using computer-enhanced visual learning

Sloane L. York*, Max Maizels, Elaine Cohen, Rachel Stork Stoltz, Adeel Jamil, William C. McGaghie, Dana R. Gossett

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Skilled performance of cesarean deliveries is essential in obstetrics and gynecology residency. A computer-enhanced visual learning module (CEVL Cesarean) was developed to teach cesarean deliveries.

Methods: An online module presented cesarean deliveries as a series of components using text, audio, video and animation. First-year residents used CEVL Cesarean and were evaluated intra-operatively by trained raters, then provided feedback about surgical performance. Clinical outcomes were collected for approximately 50 cesarean deliveries for each resident.

Results: From 2010 to 2011, 12 first-year residents participated in the study. About 406 unique observed cesarean deliveries were analyzed. Procedures up to each resident's 70th case were analyzed by grouping cases in 10s (cases 1-10 and 11-20), or deciles. Resident performance significantly improved by decile [χ2(6)=47.56, p0.001]. When examining each resident's performance, surgical skill acquisition plateaued by cases 21-30. Procedural performance, independent of resident, also improved significantly by decile [χ2(6)=186.95, p0.001], plateauing by decile 4 (cases 31-40). Throughout the observation period, operative time decreased by 3.84min (p=0.006).

Conclusions: Pre-clinical teaching using computer-based modules for cesarean sections is feasible to develop. Novice surgeons required at least 30 procedures before performing the procedure competently. When residents performed competently, operative time and complications decreased.

Original languageEnglish (US)
Pages (from-to)958-964
Number of pages7
JournalMedical Teacher
Issue number11
StatePublished - Nov 1 2014

ASJC Scopus subject areas

  • Education

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