The influence of different training schedules on the learning of psychomotor skills for endoscopic surgery

Verdaasdonk, E. G. G.; Stassen, Laurents P. S.; Wijk, R. P. J. van; Dankelman, Jenny

doi:10.1007/s00464-005-0852-8

Cited by 70 publications

(56 citation statements)

References 19 publications

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“…Although surgeons normally acquire surgical skills in short courses [30], it seems that distributed training is superior to massed training in acquiring and retaining psychomotor skills for endoscopic surgery on a VR simulator [31,32]. In our case, it was not possible to carry out a distributed program due to subject time constraints, but we consider that results obtained in our study could be also improved with a distributed training program.…”

Section: C> C> C> C> C>mentioning

confidence: 72%

Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator

et al. 2012

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Purpose Surgical simulators are currently essential within any laparoscopic training program because they provide a low-stakes, reproducible and reliable environment to acquire basic skills. The purpose of this study is to determine the training learning curve based on different metrics corresponding to Ave tasks included in SINERGIA laparoscopic virtual reality simulator. Methods Thirty medical students without surgical experience participated in the study. Five tasks of SINERGIA were included: Coordination, Navigation, Navigation and touch, Accurate grasping and Coordinated pulling. Each participant was trained in SINERGIA. This training consisted of eight sessions (R1-R8) of the Ave mentioned tasks and was carried out in two consecutive days with four sessions per day. A statistical analysis was made, and the results of Rl, R4 and R8 were pair-wise compared with Wilcoxon signed-rank test. Significance is considered at P value <0.005. Results In total, 84.38 % of the metrics provided by SINER-GIA and included in this study show significant differences when comparing Rl and R8. Metrics are mostly improved in the Arst session of training (75.00 % when Rl and R4 are compared vs. 37.50 % when R4 and R8 are compared). In tasks Coordination and Navigation and touch, all metrics psychomotor skills are improved. On the other hand, Navigation just improves 60 % of the analyzed metrics. Most learning curves show an improvement with better results in the fulfillment of the different tasks. Conclusions Learning curves of metrics that assess the basic psychomotor laparoscopic skills acquired in SINERGIA virtual reality simulator show a faster learning rate during the Arst part of the training. Nevertheless, eight repetitions of the tasks are not enough to acquire all psychomotor skills that can be trained in SINERGIA. Therefore, and based on these results together with previous works, SINERGIA could be used as training tool with a properly designed training program.

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Section: C> C> C> C> C>mentioning

confidence: 72%

Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator

et al. 2012

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“…9,12 These studies also show superiority for distributed training. The purpose of this study therefore was to investigate the effect of distributed and massed training on the initial development and retention of psychomotor skills on a virtual reality simulator.…”

Section: Introductionmentioning

confidence: 70%

“…A power analysis based on the results of time-scores analysis (relative difference 18.7%) in the study of Verdaasdonk et al 9 with a power of 0.8 and alpha set at 0.05, demonstrate a group size of 8 participants for each group.…”

Section: Sample Sizementioning

confidence: 99%

“…[1][2][3][4] Virtual reality simulators have shown to be valid and useful tools for training these psychomotor skills. [5][6][7][8][9] Working hours of residents have been limited during the last years and technical skill training should be as efficient as possible. Therefore it is very important to understand the concepts of training schedules.…”

Section: Introductionmentioning

confidence: 99%

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Distributed versus Massed Training: Efficiency of Training Psychomotor Skills

Dongen

Mitra

Schijven

et al. 2011

Surgical Techniques Development

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Virtual reality simulators have shown to be valid and useful tools for training psychomotor skills for endoscopic surgery. Discussion arises how to integrate these simulators into the surgical training curriculum. Distributed training is referred to as short training periods, with rest periods in between. Massed training is training in continuous and longer training blocks. This study investigates the difference between distributed and massed training on the initial development and retention of psychomotor skills on a virtual reality simulator. Four groups of eight medical students lacking any experience in endoscopic training were created. Two groups trained in a distributed fashion, one group trained in a massed fashion and the last group not at all (control group). All performed a post-test immediately after finishing their training schedule. Two months after this test a second post-test was performed. The one-way analysis of variance (ANOVA) with Post-Hoc test Tukey-Bonferoni was used to determine differences in mean scores between the four groups, whereas a pvalue ≤0.05 was considered to be statistically significant. Distributed training resulted in higher scores and a better retention of relevant psychomotor skills. Distributed as well as massed training resulted in better scores and retention of skills than no training at all.Our study clearly shows that distributed training yields better results in psychomotor endoscopic skills. Therefore, in order to train as efficient as possible, training programs should be (re)-programmed accordingly.

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“…24 The distribution of training over several days has also been shown to be superior to training in one day. 25 Other factors enhancing training are fellowship programmer, 26 or playing video games. 27 One can also obtain feedback for improvement of training program.…”

Section: Implications For Practice and Trainingmentioning

confidence: 99%

The Impact of the Learning Curve in Laparoscopic Surgery

Raja¹

2008

WJOLS

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TP Wright originally introduced the concept of a learning curve in aircraft manufacturing in 1936.1 He described a basic theory for costing the repetitive production of airplane assemblies. The term was introduced to medicine in the 1980s after the advent of minimal access surgery. It also caught the attention of the public and the legal profession when a surgeon told a public enquiry in Britain that a high death rate was inevitable while surgeons were on a learning curve. 2Recently it has been labeled as a dangerous curve 3 with a morbidity, mortality and unproven outcomes. Yet there is no standardization of what the term means. In an endeavor to help laparoscopic surgeons towards evidence based practices this commentary will define and describe the learning curve, its drawing followed by a discussion of the factors affecting it, statistical evaluation, effect on randomized controlled trials and clinical implications for both practice and training, the limitations and pitfalls, ethical dilemmas and some thoughts to pave the way ahead. DEFINITION AND DESCRIPTIONFor the Wright learning curve, the underlying hypothesis is that the direct man-hours necessary to complete a unit of production will decrease by a constant percentage each time the production quantity is doubled. In manufacturing, the learning curve applies to the time and cost of production. Can a surgeons learning curve be described on similar lines? A simple definition would be : the time taken and/or the number of procedures an average surgeon needs to be able to perform a procedure independently with a reasonable outcome.1 But then who is an average surgeon ? Another definition may be that a learning curve is a graphic representation of the relationship between experience with a new procedure or technique and an outcome variable such as operation time, complication rate, hospital stay or mortality. 4 A learning curve may also be operationally defined as an improvement in performance over time. Although learning theorists often disagree about what learning is, they agree that whatever the process is, its effects are clearly cumulative and may therefore be plotted as a curve. By cumulative it is meant that somehow the effects of experience carry over to aid later performance. This property is fundamental to the construction of learning curves. The improvement tends to be most rapid at first and then tails off. Hence there are three main features of a learning curve. First, the initial or starting point defines where the performance of an individual surgeon begins. Secondly, the rate of learning measures how quickly the surgeon will reach a certain level of performance and thirdly the asymptote or expert level measures where the surgeons performance stabilizes.5 This has implications for the laparoscopic surgeon-it suggests that practice always help improve performance but the most dramatic improvement happens first. Also with sufficient practice surgeons can achieve comparable levels of performance. THE DRAWING OF LEARNING CURVESThere are a ...

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The influence of different training schedules on the learning of psychomotor skills for endoscopic surgery

Cited by 70 publications

References 19 publications

Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator

Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator

Distributed versus Massed Training: Efficiency of Training Psychomotor Skills

The Impact of the Learning Curve in Laparoscopic Surgery

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