TY - JOUR
T1 - Effect of Rehearsal Modality on Knowledge Retention in Surgical Trainees
T2 - A Pilot Study
AU - Finnesgard, Eric J.
AU - Aho, Johnathon M.
AU - Pandian, T. K.
AU - Farley, David R.
N1 - Funding Information:
This publication was made possible by NHLBI grant T32 HL105355 from the National Heart, Lung, and Blood Institute , United States a component of the National Institutes of Health (NIH), United States. (Aho)
Publisher Copyright:
© 2016 Association of Program Directors in Surgery
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Objective The operating room is an exciting learning environment. With growing curriculum limitations and increasing complexity of care, existing education opportunities need to be optimized. Rehearsal has benefits for surgeon performance in the operating room, but its role for enhancing operative learning remains unclear. This pilot study aimed to differentiate the effects of physical rehearsal (PR) and cognitive rehearsal (CR) modalities on surgical trainee technical knowledge retention. Design Participants took part in a 2-day (sequential Fridays), instructed operative workshop performing midline laparotomy, splenectomy, left nephrectomy, and hand-sewn, side-to-side small bowel anastomosis (SBA). Participants were randomized to 10 minutes of either a (PR; n = 5) or (CR; n = 5) activity each day before operating. PR consisted of practicing SBA on a felt bowel model. CR entailed viewing narrated operative footage detailing the steps of SBA. Participants’ technical knowledge of all procedures was assessed at 1 and 12 weeks postworkshop using a 31-question test. Setting Animal operative suites at an academic medical center. Participants A total of 10 general surgery postgraduate year 1 interns participated in the workshop; all completed the study. Participants had similar levels of operative exposure at the time of study participation. Results At 1-week postworkshop, mean assessment scores for CR were higher than PR (Mean ± Standard Deviation) (CR = 24.7 ± 1.6 vs. PR = 21.8 ± 1.7, p = 0.02). After 12 weeks, there was no difference in mean scores (CR = 23.3 ± 2 vs. PR = 21.7 ± 1.8, p = 0.22). Knowledge decay for the 12-week period was similar between groups (CR = −1.4 ± 1.6 vs. PR = −0.1 ± 2.4, p = 0.36). Study participants performed better on SBA-related questions than unrelated questions (laparotomy, splenectomy, and nephrectomy) at 1-week (related = 81.5% ± 11.3 vs. unrelated = 71.9% ± 6.6, p = 0.03) and 12 weeks (related = 81% ± 13.1 vs. unrelated = 68.6% ± 8.8, p = 0.02). Conclusion This pilot data suggests the modality of the rehearsal activity may not significantly effect surgical learners’ technical knowledge retention. Participants did score higher on questions related to the rehearsal topic, indicating a potential supplementary role for rehearsal activities.
AB - Objective The operating room is an exciting learning environment. With growing curriculum limitations and increasing complexity of care, existing education opportunities need to be optimized. Rehearsal has benefits for surgeon performance in the operating room, but its role for enhancing operative learning remains unclear. This pilot study aimed to differentiate the effects of physical rehearsal (PR) and cognitive rehearsal (CR) modalities on surgical trainee technical knowledge retention. Design Participants took part in a 2-day (sequential Fridays), instructed operative workshop performing midline laparotomy, splenectomy, left nephrectomy, and hand-sewn, side-to-side small bowel anastomosis (SBA). Participants were randomized to 10 minutes of either a (PR; n = 5) or (CR; n = 5) activity each day before operating. PR consisted of practicing SBA on a felt bowel model. CR entailed viewing narrated operative footage detailing the steps of SBA. Participants’ technical knowledge of all procedures was assessed at 1 and 12 weeks postworkshop using a 31-question test. Setting Animal operative suites at an academic medical center. Participants A total of 10 general surgery postgraduate year 1 interns participated in the workshop; all completed the study. Participants had similar levels of operative exposure at the time of study participation. Results At 1-week postworkshop, mean assessment scores for CR were higher than PR (Mean ± Standard Deviation) (CR = 24.7 ± 1.6 vs. PR = 21.8 ± 1.7, p = 0.02). After 12 weeks, there was no difference in mean scores (CR = 23.3 ± 2 vs. PR = 21.7 ± 1.8, p = 0.22). Knowledge decay for the 12-week period was similar between groups (CR = −1.4 ± 1.6 vs. PR = −0.1 ± 2.4, p = 0.36). Study participants performed better on SBA-related questions than unrelated questions (laparotomy, splenectomy, and nephrectomy) at 1-week (related = 81.5% ± 11.3 vs. unrelated = 71.9% ± 6.6, p = 0.03) and 12 weeks (related = 81% ± 13.1 vs. unrelated = 68.6% ± 8.8, p = 0.02). Conclusion This pilot data suggests the modality of the rehearsal activity may not significantly effect surgical learners’ technical knowledge retention. Participants did score higher on questions related to the rehearsal topic, indicating a potential supplementary role for rehearsal activities.
KW - Practice-Based Learning and Improvement
KW - knowledge
KW - learning
KW - rehearsal
KW - retention
KW - surgery
KW - warm-up
UR - http://www.scopus.com/inward/record.url?scp=84975747652&partnerID=8YFLogxK
U2 - 10.1016/j.jsurg.2016.04.001
DO - 10.1016/j.jsurg.2016.04.001
M3 - Article
C2 - 27142721
AN - SCOPUS:84975747652
SN - 1931-7204
VL - 73
SP - 831
EP - 835
JO - Journal of Surgical Education
JF - Journal of Surgical Education
IS - 5
ER -