# Video-Assisted Instruction Versus Simulation-Based Mastery Learning for Lumbar Puncture Skill Development in Undergraduates: A Randomized Study

## TL;DR

A study compared two teaching methods for lumbar puncture skills in medical students and found that video-assisted learning improved initial performance, while simulation-based mastery learning led to better long-term retention.

## Contribution

The study directly compares video-assisted instruction and simulation-based mastery learning for lumbar puncture training in undergraduates, revealing distinct advantages for each method.

## Key findings

- Video-assisted instruction led to higher immediate procedural skill scores compared to simulation-based mastery learning.
- Simulation-based mastery learning showed better long-term retention of lumbar puncture skills two weeks after training.
- Both teaching methods improved knowledge significantly, but simulation-based learning had a higher retention index.

## Abstract

Background

Lumbar puncture (LP) is a technically demanding procedure fundamental for diagnosis and treatment in multiple specialties. Undergraduate medical training often provides limited opportunities for deliberate practice. Video-assisted instruction and simulation-based mastery learning (SBML) have emerged as promising educational strategies. However, direct comparisons of these modalities for LP training remain scarce.

Methods

This randomized study included 30 final-year MBBS students assigned equally to video-assisted instruction or SBML groups. Both groups received identical learning objectives and practiced LP on simulators. Knowledge was assessed before and after training using a validated questionnaire, while procedural competence was evaluated immediately and at two weeks using the objective structured assessment of technical skills (OSATS). Data were analyzed using mixed-design analysis of variance (ANOVA) and paired t-tests.

Results

The video-assisted group demonstrated significantly higher immediate OSATS scores (mean ± SD: 12.73 ± 2.12) compared to the SBML group (10.47 ± 1.81; p = .004, Cohen’s d = 1.05). At the two-week follow-up, SBML scores improved (11.93 ± 1.28), whereas video-assisted scores declined (11.53 ± 1.64), resulting in a significant group × time interaction (F(1,28) = 8.82, p = 0.004). Both groups achieved significant knowledge gains (mean difference = 1.17; p = 0.017). The retention index favored SBML (114%) compared with video-assisted instruction (91%).

Conclusion

Video-assisted instruction accelerates early acquisition of LP procedural skills, while SBML promotes superior long-term retention. Incorporating both strategies into undergraduate curricula may optimize procedural performance and durability. Such integration has the potential to improve competency development and, ultimately, patient care.