Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload

doi:10.1016/j.surg.2016.11.011

Surgery

Volume 161, Issue 5, May 2017, Pages 1209-1214

https://doi.org/10.1016/j.surg.2016.11.011 Get rights and content

Background

The effects of refraining from practice for different intervals on laparoscopic suturing and mental workload was assessed with a secondary task developed by the authors. We expected the inability to practice to produce a decrease in performance on the suturing, knot tying, and secondary task and skills to rebound after a single refresher session.

Methods

In total, 22 surgical assistant and premedical students trained to Fundamentals of Laparoscopic Surgery proficiency in intracorporeal suturing and knot tying were assessed on that task using a secondary task. Participants refrained from practicing any Fundamentals of Laparoscopic Surgery tasks for 1 or 5 months. At the time of their return, they were assessed immediately on suturing and knot tying with the secondary task, practiced suturing and knot tying for 40 minutes, and then were reassessed.

Results

The mean suture times from the initial reassessment were greater than the proficiency times but returned to proficiency levels after one practice session, F(2, 40) = 14.5, P < .001, partial η² = .420. Secondary task scores mirrored the results of suturing time, F(2, 40) = 6.128, P < .005, partial η² = .235, and were moderated by retention interval.

Conclusion

When participants who reached proficiency in suturing and knot tying were reassessed after either 1or 5 months without practice, their performance times increased by 35% and secondary task scores decreased by 30%. These deficits, however, were nearly reversed after a single refresher session.

Section snippets

Participants

Twenty-seven participants were recruited from the Master of Surgical Assisting program at Eastern Virginia Medical School (n = 22) and the premedical classes at the Univerity of North Carolina, Charlotte (n = 5). Participants were required to be unable to practice laparoscopic tasks during the retention intervals.

Primary task

Participants were assessed on the FLS intracorporeal suturing and knot tying task after having been trained previously to proficiency on this task. They were provided with 2

Results

Five participants withdrew from the study leaving 12 participants in the 1-month condition and 10 in the 5-month condition. There were 4 men and 18 women with a mean age of 25 years (standard deviation [SD] = 4). All but 2 participants were right-handed, and all had normal or corrected-to-normal vision. The primary dependent measure of performance for the suturing and knot tying task was completion time. Except for the initial practice session, participants made too few needle placement and

Discussion

The goal of this study was to examine how refraining from practice for different intervals would affect laparoscopic suturing performance and mental workload in novices trained to proficiency using a secondary task. Participants were trained to proficiency, ceased practicing for 1 or 5 months, and then returned for a retention test and refresher training session. They were assessed immediately on their return, given 40 minutes to practice, and assessed again. The results showed an increase in

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: Supported in part by a grant from the Agency for Healthcare Quality and Research (1R18HS020386-01) and the Modeling and Simulation Graduate Research Fellowship Program at Old Dominion University.

: The authors of this study have no conflicts of interest to disclose.

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2016 ACS Simulation SeriesEffects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload

Background

Methods

Results

Conclusion

Section snippets

Participants

Primary task

Results

Discussion

Am J Surg

Am J Surg

Surgery

J Surg Ed

Surgery

Surgery

Laparoscopic bile duct injury: understanding the psychology and heuristics of the error

ANZ J Surg

An objective test of perceptual skill that predicts laparoscopic technical skill in three initial studies of laparoscopic performance

Surg Endosc

Experienced surgeons can do more than one thing at a time: effect of distraction on performance of a simple laparoscopic and cognitive task by experienced and novice surgeons

Surg Endosc

Multiple resources and performance prediction

Theor Issues Ergon Sci

2016 ACS Simulation Series
Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload