AI Article Synopsis
- The study compares two learning methods for surgical trainees performing clavicle plate placements: naive practice (NP), which involves watching an expert video before each trial, and deliberate practice (DP), where trainees receive personalized feedback after each attempt.
- Results showed that trainees using DP had significantly better objective performance scores and greater improvements over time compared to those using NP, indicating that structured feedback enhances learning.
- Although DP led to better performance outcomes, it was also associated with higher stress levels, as measured by an analgesia-nociception index, suggesting a trade-off between effective learning and the stress of performance evaluation.
Article Abstract
Background: Companionship and simple experience or naive practice (NP) rarely lead to expert level surgery, in contrast to deliberate practice (DP) where an expert analyzes the learner's errors and sets goals to improve performance. The main hypothesis was that using DP for learning would result in faster and/or greater progress than using NP.
Objectives: The objective of this work was to compare the evolution of the learning curve for clavicle locking plate placement on a sawbone model of a clavicle fracture, by surgical trainees learning via two different methods; NP and DP.
Patients And Methods: Ten surgical residents, divided into 2 groups of 5, each placed 6 plates. The 6 trials were filmed. The NP group saw an expert video before each placement. The DP group saw this video once and then received personalized advice from the expert for improvement, by analyzing their own video after each subsequent trial. Objective performance (OP) was measured by a standardized evaluation grid (OSATS, with a score ranging from 10 to 50 points per trial), self-evaluation of performance by a numerical scale (from 0 to 10) and stress by an analgesia-nociception index (ANI, calculated by heart rate recording, from 0 to 100).
Results: The mean OP at the last trial of clavicle plate placement was 41.8 (NP group) and 48.2 (DP group), with a mean progression from the first to last trials of 0.8 in the NP group, and 5.1 in the DP group. The mean progression in self-evaluation between the first and last trials was 3.4 (NP group) and 4.6 (DP group). The mean progression of the ANI between the first and last trials was -4.5 (NP group) and +5 (DP group).
Discussion: The results of learning a clavicle plate osteosynthesis technique measured by OSATS were better with deliberate practice than with naive practice. The progression in self-evaluated performance was better with deliberate practice, but with a higher stress level.
Conclusion: Deliberate practice is a technique for learning the surgical procedure which complements companionship and experience. It shortens the learning curve and improves the level of performance of surgical trainees.
Level Of Evidence: IV; non-interventional research.
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| http://dx.doi.org/10.1016/j.otsr.2024.103951 | DOI Listing |
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