Evidence supporting a virtual case-based module to improve cognitive foundation for the management of laparoscopic appendectomy

Purpose Case-based learning (CBL) is an established clinical learning approach, where learners apply knowledge within real-world scenarios. Little evidence exists on applicability of virtual CBL among surgical learners, particularly in low- and middle-income countries (LMICs). Methods An 18-item interactive, web-based CBL module and 10-item pre/post-module quiz assessing knowledge of acute appendicitis laparoscopic management was created. The module was validated by Ethiopian, Cameroonian, and US surgeons and a psychometrician for content, relevance, and clarity. Twenty-two participants categorized as novice ( n = 14), intermediate ( n = 5), and expert ( n = 3) across three sites (Ethiopia, Cameroon, US) completed the module. Comparisons across pre- and post-module summed scores and experience levels were performed using paired student-test, and one-way ANOVA, respectively, while item-level analyses were performed using a Rasch model. Results Significant improvement in mean summed scores from pre- to post-quiz was observed for novice ( P