Neha Malhotra1, Jamie M Poolton2, Mark R Wilson3, Gilberto Leung4, Frank Zhu5, Joe K M Fan4, Rich S W Masters6. 1. Institute of Human Performance, The University of Hong Kong, Hong Kong, China. Electronic address: nehamal@connect.hku.hk. 2. Institute of Human Performance, The University of Hong Kong, Hong Kong, China; School of Sport, Carnegie Faculty, Leeds Beckett University, United Kingdom. 3. School of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, United Kingdom. 4. Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. 5. Institute of Human Performance, The University of Hong Kong, Hong Kong, China; Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. 6. Institute of Human Performance, The University of Hong Kong, Hong Kong, China; Department of Sport and Leisure Studies, University of Waikato, New Zealand.
Abstract
BACKGROUND: Surgical educators have encouraged the investigation of individual differences in aptitude and personality in surgical performance. An individual personality difference that has been shown to influence laparoscopic performance under time pressure is movement specific reinvestment. Movement specific reinvestment has 2 dimensions, movement self-consciousness (MS-C) (i.e., the propensity to consciously monitor movements) and conscious motor processing (CMP) (i.e., the propensity to consciously control movements), which have been shown to differentially influence laparoscopic performance in practice but have yet to be investigated in the context of psychological stress (e.g., the objective structured clinical examination [OSCE]). OBJECTIVE: This study investigated the role of individual differences in propensity for MS-C and CMP in practice of a fundamental laparoscopic skill and in laparoscopic performance during the OSCE. Furthermore, this study examined whether individual differences during practice of a fundamental laparoscopic skill were predictive of laparoscopic performance during the OSCE. METHODS: Overall, 77 final-year undergraduate medical students completed the movement specific reinvestment scale, an assessment tool that quantifies the propensity for MS-C and CMP. Participants were trained to proficiency on a fundamental laparoscopic skill. The number of trials to reach proficiency was measured, and completion times were recorded during early practice, later practice, and the OSCE. RESULTS: There was a trend for CMP to be negatively associated with the number of trials to reach proficiency (p = 0.064). A higher propensity for CMP was associated with fewer trials to reach proficiency (β = -0.70, p = 0.023). CMP and MS-C did not significantly predict completion times in the OSCE (p > 0.05). Completion times in early practice (β = 0.05, p = 0.016) and later practice (β = 0.47, p < 0.001) and number of trials to reach proficiency (β = 0.23, p = 0.003) significantly predicted completion times in the OSCE. CONCLUSION: It appears that a higher propensity for CMP predicts faster rates of learning of a fundamental laparoscopic skill. Furthermore, laparoscopic performance during practice is indicative of laparoscopic performance in the challenging conditions of the OSCE. The lack of association between the 2 dimensions of movement specific reinvestment and performance during the OSCE is explained using the theory of reinvestment as a framework. Overall, consideration of personality differences and individual differences in ability during practice could help inform the development of individualized surgical training programs.
BACKGROUND: Surgical educators have encouraged the investigation of individual differences in aptitude and personality in surgical performance. An individual personality difference that has been shown to influence laparoscopic performance under time pressure is movement specific reinvestment. Movement specific reinvestment has 2 dimensions, movement self-consciousness (MS-C) (i.e., the propensity to consciously monitor movements) and conscious motor processing (CMP) (i.e., the propensity to consciously control movements), which have been shown to differentially influence laparoscopic performance in practice but have yet to be investigated in the context of psychological stress (e.g., the objective structured clinical examination [OSCE]). OBJECTIVE: This study investigated the role of individual differences in propensity for MS-C and CMP in practice of a fundamental laparoscopic skill and in laparoscopic performance during the OSCE. Furthermore, this study examined whether individual differences during practice of a fundamental laparoscopic skill were predictive of laparoscopic performance during the OSCE. METHODS: Overall, 77 final-year undergraduate medical students completed the movement specific reinvestment scale, an assessment tool that quantifies the propensity for MS-C and CMP. Participants were trained to proficiency on a fundamental laparoscopic skill. The number of trials to reach proficiency was measured, and completion times were recorded during early practice, later practice, and the OSCE. RESULTS: There was a trend for CMP to be negatively associated with the number of trials to reach proficiency (p = 0.064). A higher propensity for CMP was associated with fewer trials to reach proficiency (β = -0.70, p = 0.023). CMP and MS-C did not significantly predict completion times in the OSCE (p > 0.05). Completion times in early practice (β = 0.05, p = 0.016) and later practice (β = 0.47, p < 0.001) and number of trials to reach proficiency (β = 0.23, p = 0.003) significantly predicted completion times in the OSCE. CONCLUSION: It appears that a higher propensity for CMP predicts faster rates of learning of a fundamental laparoscopic skill. Furthermore, laparoscopic performance during practice is indicative of laparoscopic performance in the challenging conditions of the OSCE. The lack of association between the 2 dimensions of movement specific reinvestment and performance during the OSCE is explained using the theory of reinvestment as a framework. Overall, consideration of personality differences and individual differences in ability during practice could help inform the development of individualized surgical training programs.
Keywords:
Medical Knowledge; OSCE; Patient Care; Practice-Based Learning and Improvement; conscious motor processing; individual differences; laparoscopic training; movement self-consciousness; movement specific reinvestment
Authors: Suzanne Perry; Susan M Bridges; Frank Zhu; W Keung Leung; Michael F Burrow; Jamie Poolton; Rich Sw Masters Journal: J Med Internet Res Date: 2017-12-12 Impact factor: 5.428
Authors: Jamie M Poolton; Frank F Zhu; Neha Malhotra; Gilberto K K Leung; Joe K M Fan; Rich S W Masters Journal: Surg Endosc Date: 2016-01-07 Impact factor: 4.584
Authors: Kirsty L Beattie; Andrew Hill; Mark S Horswill; Philip M Grove; Andrew R L Stevenson Journal: Surg Endosc Date: 2021-08-09 Impact factor: 4.584