Becca L Gas1, EeeLN H Buckarma, David A Cook, David R Farley, Martin V Pusic. 1. B.L. Gas is education specialist, Center for Clinical and Translational Sciences and Department of Subspecialty General Surgery, Mayo Clinic, Rochester, Minnesota; ORCID: http://orcid.org/0000-0002-7140-4956. E.H. Buckarma is general surgery resident, Department of Subspecialty General Surgery, Mayo Clinic, Rochester, Minnesota; ORCID: http://orcid.org/0000-0002-6396-3176. D.A. Cook is professor of medicine and medical education; chair, Mayo Clinic Multidisciplinary Simulation Center Research Committee; and consultant, Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota; ORCID: http://orcid.org/0000-0003-2383-4633. D.R. Farley is professor of surgery and consultant, Department of Subspecialty General Surgery, Mayo Clinic, Rochester, Minnesota; ORCID: http://orcid.org/0000-0002-2970-5114. M.V. Pusic is associate professor of emergency medicine, Department of Emergency Medicine, and director, Division of Learning Analytics, Institute for Innovations in Medical Education, NYU School of Medicine, New York, New York; ORCID: http://orcid.org/0000-0001-5236-6598.
Abstract
PURPOSE: To determine whether "chronometric pressure" (i.e., a verbal prompt to increase speed) could predictably alter medical learners' speed-accuracy trade-off during a simulated surgical task, thus modifying the challenge. METHOD: The authors performed a single-task, interrupted time-series study, enrolling surgery residents and medical students from two institutions in September and October 2015. Participants completed 10 repetitions of a simulated blood vessel ligation (placement of two ligatures 1 cm apart). Between repetitions 5 and 6, participants were verbally encouraged to complete the next repetition 20% faster than the previous one. Outcomes included time and accuracy (ligature tightness, placement distance). Data were analyzed using random-coefficients spline models. RESULTS: The authors analyzed data from 78 participants (25 medical students, 16 first-year residents, 37 senior [second-year or higher] residents). Overall, time decreased from the 1st (mean [standard deviation] 39.8 seconds [18.4]) to the 10th (29.6 [12.5]) repetition. The spline model showed a decrease in time between repetitions 5 and 6 of 8.6 seconds (95% confidence interval: -11.1, -6.1). The faster time corresponded with declines in ligature tightness (unadjusted difference -19%; decrease in odds 0.86 [0.76, 0.98]) and placement accuracy (unadjusted difference -5%; decrease in odds 0.86 [0.75, 0.99]). Significant differences in the speed-accuracy trade-off were seen by training level, with senior residents demonstrating the greatest decline in accuracy as speed increased. CONCLUSIONS: Chronometric pressure influenced the speed-accuracy trade-off and modified the challenge level in a simulated surgical task. It may help unmask correctable deficiencies or false plateaus in learners' skill development.
PURPOSE: To determine whether "chronometric pressure" (i.e., a verbal prompt to increase speed) could predictably alter medical learners' speed-accuracy trade-off during a simulated surgical task, thus modifying the challenge. METHOD: The authors performed a single-task, interrupted time-series study, enrolling surgery residents and medical students from two institutions in September and October 2015. Participants completed 10 repetitions of a simulated blood vessel ligation (placement of two ligatures 1 cm apart). Between repetitions 5 and 6, participants were verbally encouraged to complete the next repetition 20% faster than the previous one. Outcomes included time and accuracy (ligature tightness, placement distance). Data were analyzed using random-coefficients spline models. RESULTS: The authors analyzed data from 78 participants (25 medical students, 16 first-year residents, 37 senior [second-year or higher] residents). Overall, time decreased from the 1st (mean [standard deviation] 39.8 seconds [18.4]) to the 10th (29.6 [12.5]) repetition. The spline model showed a decrease in time between repetitions 5 and 6 of 8.6 seconds (95% confidence interval: -11.1, -6.1). The faster time corresponded with declines in ligature tightness (unadjusted difference -19%; decrease in odds 0.86 [0.76, 0.98]) and placement accuracy (unadjusted difference -5%; decrease in odds 0.86 [0.75, 0.99]). Significant differences in the speed-accuracy trade-off were seen by training level, with senior residents demonstrating the greatest decline in accuracy as speed increased. CONCLUSIONS: Chronometric pressure influenced the speed-accuracy trade-off and modified the challenge level in a simulated surgical task. It may help unmask correctable deficiencies or false plateaus in learners' skill development.
Authors: Cristina Andrada Costea; Dora Maria Popescu; Alexandra Roman; Ștefan-Ioan Stratul; Petra Șurlin; Marius Negucioiu; Iulia Cristina Micu; Andreea Ciurea; Patricia Ondine Lucaciu; Luminița Lazăr; Doina Elena Mircioagă; Andrada Soancă Journal: Int J Environ Res Public Health Date: 2022-04-08 Impact factor: 4.614