Effect of problem and scripting-based learning on spine surgical trainees' learning outcomes.

Purpose: To assess the impact of problem and scripting-based learning (PSBL) on spine surgical trainees' learning outcomes.
Methods: 30 spine surgery postgraduate-year-1 residents (PGY-1s) from the First Hospital of China Medical University were randomly divided into two groups. The first group studied spine surgical skills and developed individual judgment under a conventional didactic model, whereas the PSBL group used PBL and Scripted model. A feedback questionnaire and the satisfaction of residents were evaluated by the first assistant surgeon immediately following each procedure. At the end of the study, residents filled out questionnaires focused on identifying the strengths of each teaching method and took a multiple-choice theoretical examination. The results were analyzed by t tests.
Results: Significant difference was found between the two groups in total mean score of preparedness and performance feedback statement (P = 0.01) and the questionnaire by PGY-1's opinion on the effectiveness of the two teaching methods (P = 0.004). Compared with the non-PSBL group, the PSBL group had significantly higher mean score of pre-operative preparedness (P = 0.01), but there was no significant difference between the two groups in theoretical examination, intra-operative performance, and overall satisfaction with the PGY-1s. The residents found that PSBL could develop their judgment (P = 0.03) and provide greater satisfaction (P = 0.02), and would like to repeat the experience (P = 0.03).
Conclusions: The PSBL method can activate spine residents' prior knowledge and building on existing cognitive frameworks, which is an important tool for improving pre-operative preparedness. We believe that PSBL is an important first step in training spine residents to become confident and safe spine surgeons.