Amin Madani1,2, Yusuke Watanabe3,4, Melina C Vassiliou5,6, Pascal Fuchshuber7, Daniel B Jones8, Steven D Schwaitzberg9, Gerald M Fried10,11, Liane S Feldman12,13. 1. Department of Surgery, McGill University, Montreal, QC, H3G 1A4, Canada. amin.madani@mail.mcgill.ca. 2. Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm L9-309, Montreal, QC, Canada. amin.madani@mail.mcgill.ca. 3. Department of Surgery, McGill University, Montreal, QC, H3G 1A4, Canada. ywatanabe328@gmail.com. 4. Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm L9-309, Montreal, QC, Canada. ywatanabe328@gmail.com. 5. Department of Surgery, McGill University, Montreal, QC, H3G 1A4, Canada. melina.vassiliou@mcgill.ca. 6. Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm L9-309, Montreal, QC, Canada. melina.vassiliou@mcgill.ca. 7. The Permanente Medical Group, Kaiser Medical Center, Walnut Creek, CA, USA. pascal.fuchshuber@kp.org. 8. Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA. djones1@bidmc.harvard.edu. 9. Department of Surgery, Cambridge Health Alliance, Cambridge, MA, USA. sschwaitzberg@challiance.org. 10. Department of Surgery, McGill University, Montreal, QC, H3G 1A4, Canada. gerald.fried@mcgill.ca. 11. Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm L9-309, Montreal, QC, Canada. gerald.fried@mcgill.ca. 12. Department of Surgery, McGill University, Montreal, QC, H3G 1A4, Canada. liane.feldman@mcgill.ca. 13. Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm L9-309, Montreal, QC, Canada. liane.feldman@mcgill.ca.
Abstract
BACKGROUND: Despite the value of simulation for surgical training, it is unclear whether acquired competencies persist long term. A prior randomized trial showed that structured simulation improves knowledge of the safe use of electrosurgery (ES) amongst trainees up to 3 months after the curriculum (Madani et al. in Surg Endosc 28(10):2772-2782, 2014). We now analyse long-term knowledge retention. This study estimates the effects of a structured simulation-based curriculum to teach the safe use of ES on knowledge after 1 year. METHODS: Trainees previously participated in a 1-h didactic ES course, followed by randomization into one of two groups: an unstructured hands-on session where trainees used ES devices (control group) or a goal-directed hands-on training session (Sim group). Knowledge of pre- and post-curriculum (immediate, 3 months and 1 year) and knowledge of ES safety were assessed using different multiple-choice examinations. Data are expressed as median (interquartile range), *p < 0.05. RESULTS:Fifty-nine trainees participated (30 control group; 29 Sim group). Despite equal baseline examination scores, Sim group demonstrated higher scores compared to control immediately (89% [83; 94] vs. 83% [71; 86]*), 3 months (77% [69; 90] vs. 60% [51; 80]*) and 1 year after curriculum (70% [61; 74] vs. 60% [31; 71]*). One-year score remained significantly greater compared to baseline in the Sim group (70% [61; 74] vs. 49% [43; 57]*), but was similar to baseline in the control group (60% [31; 71] vs. 45% [34; 52]). CONCLUSIONS: After ES simulation training, retention of competencies persists longer when the hands-on component is designed to reinforce specific learning objectives in a structured curriculum. Despite routine clinical use of ES devices, knowledge degrades overtime, suggesting the need for ongoing formal educational activities to reinforce curricular objectives.
RCT Entities:
BACKGROUND: Despite the value of simulation for surgical training, it is unclear whether acquired competencies persist long term. A prior randomized trial showed that structured simulation improves knowledge of the safe use of electrosurgery (ES) amongst trainees up to 3 months after the curriculum (Madani et al. in Surg Endosc 28(10):2772-2782, 2014). We now analyse long-term knowledge retention. This study estimates the effects of a structured simulation-based curriculum to teach the safe use of ES on knowledge after 1 year. METHODS: Trainees previously participated in a 1-h didactic ES course, followed by randomization into one of two groups: an unstructured hands-on session where trainees used ES devices (control group) or a goal-directed hands-on training session (Sim group). Knowledge of pre- and post-curriculum (immediate, 3 months and 1 year) and knowledge of ES safety were assessed using different multiple-choice examinations. Data are expressed as median (interquartile range), *p < 0.05. RESULTS: Fifty-nine trainees participated (30 control group; 29 Sim group). Despite equal baseline examination scores, Sim group demonstrated higher scores compared to control immediately (89% [83; 94] vs. 83% [71; 86]*), 3 months (77% [69; 90] vs. 60% [51; 80]*) and 1 year after curriculum (70% [61; 74] vs. 60% [31; 71]*). One-year score remained significantly greater compared to baseline in the Sim group (70% [61; 74] vs. 49% [43; 57]*), but was similar to baseline in the control group (60% [31; 71] vs. 45% [34; 52]). CONCLUSIONS: After ES simulation training, retention of competencies persists longer when the hands-on component is designed to reinforce specific learning objectives in a structured curriculum. Despite routine clinical use of ES devices, knowledge degrades overtime, suggesting the need for ongoing formal educational activities to reinforce curricular objectives.
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