TY - JOUR
T1 - Proficiency maintenance
T2 - Impact of ongoing simulator training on laparoscopic skill retention
AU - Stefanidis, Dimitrios
AU - Korndorffer, James R.
AU - Markley, Sarah
AU - Sierra, Rafael
AU - Scott, Daniel J.
PY - 2006/4
Y1 - 2006/4
N2 - BACKGROUND: Proficiency-based training in laparoscopic suturing and knot tying translates to the operating room, but little is known about the durability of acquired skill. The purpose of this study was to determine the effect of maintenance training on skill retention after demonstration of proficiency. STUDY DESIGN: Medical students (n = 18) with no previous laparoscopic or simulator experience were enrolled in an IRB-approved randomized controlled trial. All subjects trained to proficiency (score of 512, based on time and errors) on a previously validated suturing model (Fundamentals of Laparoscopic Surgery videotrainer). Subjects were then randomized to a control group, which received no additional training, and an ongoing training group, which trained again to proficiency at 1 and 3months (immediately after testing). Simulator testing was repeated at 2weeks, 1month, 3months, and 6months after initial training. No subject had interval operative experience. RESULTS: Both groups demonstrated excellent skill retention during followup; performance scores, reported as means ± SD, were 488 ± 57 versus 482 ± 55 at 2weeks (p = ns), 483 ± 81 versus 491 ± 64 at 1month (p = ns), 467 ± 75 versus 470 ± 67 at 3months (p = ns), and 462 ± 62 versus 492 ± 43 at 6months (p = 0.02) for the control versus ongoing training groups, respectively. At 6months, the ongoing training group showed better skill retention (95% versus 90%; p = 0.02) and a trend for achieving the proficiency level (33% versus 18%; p = 0.2) more often than the control group. CONCLUSIONS: Although proficiency-based training results in excellent skill retention, ongoing training substantially enhances performance and minimizes skill loss. Curricula should incorporate training that fosters maintenance of proficiency.
AB - BACKGROUND: Proficiency-based training in laparoscopic suturing and knot tying translates to the operating room, but little is known about the durability of acquired skill. The purpose of this study was to determine the effect of maintenance training on skill retention after demonstration of proficiency. STUDY DESIGN: Medical students (n = 18) with no previous laparoscopic or simulator experience were enrolled in an IRB-approved randomized controlled trial. All subjects trained to proficiency (score of 512, based on time and errors) on a previously validated suturing model (Fundamentals of Laparoscopic Surgery videotrainer). Subjects were then randomized to a control group, which received no additional training, and an ongoing training group, which trained again to proficiency at 1 and 3months (immediately after testing). Simulator testing was repeated at 2weeks, 1month, 3months, and 6months after initial training. No subject had interval operative experience. RESULTS: Both groups demonstrated excellent skill retention during followup; performance scores, reported as means ± SD, were 488 ± 57 versus 482 ± 55 at 2weeks (p = ns), 483 ± 81 versus 491 ± 64 at 1month (p = ns), 467 ± 75 versus 470 ± 67 at 3months (p = ns), and 462 ± 62 versus 492 ± 43 at 6months (p = 0.02) for the control versus ongoing training groups, respectively. At 6months, the ongoing training group showed better skill retention (95% versus 90%; p = 0.02) and a trend for achieving the proficiency level (33% versus 18%; p = 0.2) more often than the control group. CONCLUSIONS: Although proficiency-based training results in excellent skill retention, ongoing training substantially enhances performance and minimizes skill loss. Curricula should incorporate training that fosters maintenance of proficiency.
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U2 - 10.1016/j.jamcollsurg.2005.12.018
DO - 10.1016/j.jamcollsurg.2005.12.018
M3 - Article
C2 - 16571429
AN - SCOPUS:33645323476
SN - 1072-7515
VL - 202
SP - 599
EP - 603
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 4
ER -