Enhancement of Medical Interns' Levels of Clinical Skills Competence and Self-Confidence Levels via Video iPods: Pilot Randomized Controlled Trial

Margaret M. Hansen EdD, MSN, RN, University of San Francisco
George Oosthuizen
John Windsor
Iain Doherty
Samuel Greig
Karina McHardy
Lloyd McCann

Copyright ©Margaret Hansen, George Oosthuizen, John Windsor, Iain Doherty, Samuel Greig, Karina McHardy, Lloyd McCann. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.03.2011.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.



Designing and delivering evidence-based medical practice for students requires careful consideration from medical science educators. Social Web (Web 2.0) applications are a part of today’s educational technology milieu; however, empirical research is lacking to support the impact of interactive Web 2.0 mobile applications on medical educational outcomes.


The aim of our study was to determine whether instructional videos provided by iPod regarding female and male urinary catheter insertion would increase students’ confidence levels and enhance skill competencies.


We conducted a prospective study with medical trainee intern (TI) participants: 10 control participants (no technological intervention) and 11 intervention participants (video iPods). Before taking part in a skills course, they completed a questionnaire regarding previous exposure to male and female urinary catheterization and their level of confidence in performing the skills. Directly following the questionnaire, medical faculty provided a 40-minute skills demonstration in the Advanced Clinical Skills Centre (ACSC) laboratory at the University of Auckland, New Zealand. All participants practiced the skills following the demonstrations and were immediately evaluated by the same faculty using an assessment rubric. Following the clinical skill evaluation, participants completed a postcourse questionnaire regarding skill confidence levels. At the end of the skills course, the intervention group were provided video iPods and viewed a male and a female urinary catheterization video during the next 3 consecutive months. The control group did not receive educational technology interventions during the 3-month period. At the end of 3 months, participants completed a follow-up questionnaire and a clinical assessment of urinary catheterization skills at the ACSC lab.


The results indicate a decline in skill competency over time among the control group for both male and female catheterizations, whereas the competency level was stable among the experimental group for both procedures. Interaction results for competency scores indicate a significant level by group and time (P = .03) and procedure and group (P = .02). The experimental group’s confidence level for performing the female catheterization procedure differed significantly over time (P < .001). Furthermore, confidence scores in performing female catheterizations increased for both groups over time. However, the confidence levels for both groups in performing the male catheterization decreased over time.


Video iPods offer a novel pedagogical approach to enhance medical students’ medical skill competencies and self-confidence levels. The outcomes illustrate a need for further investigation in order to generalize to the medical school population.

Keywords: Medical education, healthcare, mobile technology, urinary catheterisation