How much feedback is necessary for learning to suture?

Full Abstract

BACKGROUND:
Many laparoscopic simulation training systems exist and have been shown to transfer learning of surgical skills to the operating room. The manner in which the training is structured to maximize learning has not been examined. There are many aspects to the acquisition of laparoscopic skills during training, one of which is the availability of knowledge of results (KR). Knowledge of results is information about the outcome of motor skill execution, usually provided to individuals at the end of the execution. The timing and nature of KR can affect how well people learn new motor skills. In addition, detailed instruction during learning can also affect skill acquisition. We studied the effects of KR and instruction on the learning curve of a suturing and knot-tying task. We hypothesized that KR was necessary for skill acquisition, and that detailed instruction would help trainees to learn to perform the task more correctly and reach a performance plateau earlier. In addition, the overall workload of a trainee during training would decrease as skills improved, especially when KR and coaching were provided.

METHODS:
Nine medical students with no previous laparoscopic surgical experience were randomly and evenly divided into three groups with different KR conditions:
(1) no KR, (2) KR, (3) KR + instruction. Each subject attended a training session for 1 h each day, 6 days a week for 4 consecutive weeks. Performance measures such as task time, smoothness of instrument, and path length were recorded for each trial. Workload was assessed using the NASA-TLX questionnaire.

RESULTS:
While KR was necessary for learning to suture, continual instruction had limited additional benefits. However, KR + instruction did reduce subjects' perceived overall workload.

CONCLUSIONS:
Surgical training could be carried out effectively with only knowledge of results. These results have implications for the staffing of surgical skills laboratories.

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Author information

Author/s: O'Connor, A (A); Schwaitzberg, S D (SD); Cao, C G L (CG);

Affiliation: Department of Mechanical Engineering, Tufts University, 200 College Avenue, Medford, Massachusetts 02155, USA.

Journal and publication information

Publication Type: Comparative Study; Journal Article; Randomized Controlled Trial

Journal: Surgical endoscopy (Surg Endosc), published in Germany. (Language: eng)

Reference: 2008-Jul; vol 22 (issue 7) : pp 1614-9

Dates: Created 2008/06/09; Completed 2008/06/26;

PMID: 17973165, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Education, Medical, Undergraduate - methods
Feedback
Female
Humans
Laparoscopy - methods

Male
Students, Medical
Suture Techniques - education
Teaching - methods
United States

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