Surgical cognitive simulation improves real-world surgical performance: randomized study.
Journal
BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685
Informations de publication
Date de publication:
07 05 2021
07 05 2021
Historique:
received:
03
11
2020
accepted:
17
12
2020
entrez:
22
5
2021
pubmed:
23
5
2021
medline:
15
12
2021
Statut:
ppublish
Résumé
Despite the acknowledgement of human factors, application of psychological methods by surgeons to improve surgical performance is sparse. This may reflect the paucity of evidence that would help surgeons to use psychological techniques effectively. There is a need for novel approaches to see how cognitive training might be used to address these challenges. Surgical trainees were divided into intervention and control groups. The intervention group received training in surgical cognitive simulation (SCS) and was asked to apply the techniques while working in operating theatres. Both groups underwent procedure-based assessment based on the UK and Ireland Intercollegiate Surgical Curriculum Programme (ISCP) before the training and 4 months afterwards. Subjective evaluations of SCS application were obtained from the intervention group participants. Among 21 participants in the study, there was a statistically significant improvement in 11 of 16 procedure-based assessment domains (P < 0.050) as well as a statistically significant mean reduction in time to complete the procedure in the intervention group (-15.98 versus -1.14 min; P = 0.024). Subjectively, the intervention group experienced various benefits with SCS, especially in preoperative preparedness, intraoperative focus, and overall performance. SCS training has a statistically significant impact in improving surgical performance. Subjective feedback suggests that surgeons are able to apply it in practice. SCS may prove a vital adjunct for skill acquisition in surgical training.
Sections du résumé
BACKGROUND
Despite the acknowledgement of human factors, application of psychological methods by surgeons to improve surgical performance is sparse. This may reflect the paucity of evidence that would help surgeons to use psychological techniques effectively. There is a need for novel approaches to see how cognitive training might be used to address these challenges.
METHODS
Surgical trainees were divided into intervention and control groups. The intervention group received training in surgical cognitive simulation (SCS) and was asked to apply the techniques while working in operating theatres. Both groups underwent procedure-based assessment based on the UK and Ireland Intercollegiate Surgical Curriculum Programme (ISCP) before the training and 4 months afterwards. Subjective evaluations of SCS application were obtained from the intervention group participants.
RESULTS
Among 21 participants in the study, there was a statistically significant improvement in 11 of 16 procedure-based assessment domains (P < 0.050) as well as a statistically significant mean reduction in time to complete the procedure in the intervention group (-15.98 versus -1.14 min; P = 0.024). Subjectively, the intervention group experienced various benefits with SCS, especially in preoperative preparedness, intraoperative focus, and overall performance.
CONCLUSION
SCS training has a statistically significant impact in improving surgical performance. Subjective feedback suggests that surgeons are able to apply it in practice. SCS may prove a vital adjunct for skill acquisition in surgical training.
Identifiants
pubmed: 34021326
pii: 6280341
doi: 10.1093/bjsopen/zrab003
pmc: PMC8140200
pii:
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Medical Research Council
ID : MC_PC_17165
Pays : United Kingdom
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd.
Références
Surgery. 2010 May;147(5):640-5
pubmed: 20403516
Br J Surg. 2013 Dec;100(13):1675-6
pubmed: 24227351
Ann Surg. 2011 Feb;253(2):265-70
pubmed: 21245669
J Am Coll Surg. 2011 Feb;212(2):225-33
pubmed: 21276534
J Am Coll Surg. 2007 Aug;205(2):307-13
pubmed: 17660078
Am J Surg. 2015 Sep;210(3):545-53
pubmed: 26092443
J Surg Educ. 2012 Mar-Apr;69(2):190-5
pubmed: 22365864
World Neurosurg. 2011 Sep-Oct;76(3-4):214-5
pubmed: 21986407
Med Educ. 2001 Sep;35(9):909-15
pubmed: 11555230
Exp Brain Res. 2017 Oct;235(10):3049-3057
pubmed: 28733754
J Gastrointest Surg. 2008 Feb;12(2):213-21
pubmed: 17926105
ANZ J Surg. 2017 Nov;87(11):873-878
pubmed: 28851014
Ann Surg. 2021 Jul 1;274(1):195-198
pubmed: 31469750
Qual Saf Health Care. 2004 Oct;13 Suppl 1:i80-4
pubmed: 15465960
BMC Med Educ. 2020 Jul 14;20(1):221
pubmed: 32664909
Med Educ. 2008 Jun;42(6):607-12
pubmed: 18435713
J Laparoendosc Adv Surg Tech A. 2017 May;27(5):459-469
pubmed: 28225325
Surg Endosc. 2004 Jan;18(1):115-20
pubmed: 14625735
Ann R Coll Surg Engl. 2018 May;100(5):401-405
pubmed: 29543056
J Surg Educ. 2020 Nov - Dec;77(6):1377-1391
pubmed: 32773335
J Otolaryngol. 2005 Oct;34(5):328-32
pubmed: 16181595
ANZ J Surg. 2019 Dec;89(12):1567-1576
pubmed: 31621178
Front Psychol. 2017 Aug 17;8:1360
pubmed: 28861013
Ann Transl Med. 2016 Dec;4(23):453
pubmed: 28090509
Br J Surg. 2015 Jan;102(1):37-44
pubmed: 25332065
BJOG. 2012 Aug;119(9):1040-8
pubmed: 22676644
Cochrane Database Syst Rev. 2014 Jan 17;(1):CD010479
pubmed: 24442763
J Am Coll Surg. 2005 Jul;201(1):23-9
pubmed: 15978440
Bull Am Coll Surg. 2011 Aug;96(8):17-22
pubmed: 22319907
Surgeon. 2017 Aug;15(4):231-239
pubmed: 27658665