Reducing cognitive load through early exposure: the role of video-based learning in microsurgical training—a pilot randomized two-group educational efficacy study

Video-based instruction is widely used in surgical training, but the timing and structure of its integration into procedural education remain variable. There is limited empirical evidence on whether viewing procedural videos prior to in-person instruction improves learning outcomes in microsurgical training. 1. Determine whether pre-class exposure to surgical video content improves early procedural comprehension and reduces technical errors in microsurgical skill acquisition. 2.Explore whether repeated viewing of the same video further improves training and learning outcomes. Forty-four postgraduate trainees were randomized into two groups: one received a video to watch at home the night before the in-lab training (full protocol group, FP), and the other received no prior exposure (control group, NV). Both groups completed the same training protocol, which included an in-class viewing session and a hands-on microsurgical task. Surveys were used to track information retention and perceived novelty at multiple time points. Procedural errors were recorded and analyzed. Data were compared using independent t-tests and proportional measures, including odds ratios and relative risk reductions. Participants in the full protocol group reported acquiring fewer new procedural steps during the in-lab session (mean 3.56 vs. 5.13; p = 0.013), suggesting better initial retention. Error analysis reveals a directional reduction in technical errors, including a 17% absolute reduction in poor bite sizing and a modest decrease in back-wall injuries. These differences reflect improved readiness and reduced novelty perception following early exposure, but did not reach statistical significance. Structured preoperative video viewing can improve early procedural readiness and reduce technical errors during microsurgical training. The results support a stronger role for video-based instruction as a foundational component rather than a supplemental one in surgical education. However, given the limited sample size and the lack of consistent statistical significance in the technical error analysis, the findings in this investigation should be interpreted as preliminary. Further studies incorporating blinded, long-term technical assessments will help confirm the results of this study.