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Conference Paper: The Impact of Verbal Guidance on Laparoscopic Skills Training and Multi-tasking Performance

TitleThe Impact of Verbal Guidance on Laparoscopic Skills Training and Multi-tasking Performance
Authors
Issue Date2010
PublisherSociety of American Gastrointestinal and Endoscopic Surgeons (SAGES). The conference's web site is located at http://www.sages.org/
Citation
SAGES 2010, 12th World Congress of Endoscopic Surgery, Landover, Maryland, USA, 14-17 April 2010, p. P207 How to Cite?
AbstractIntroduction: Evidence from studies of implicit motor learning suggest that advantages accrue from discouraging the build up of verbal knowledge about the movements that constitute a skill. The advantages include performance that is impervious to demands present in challenging task environments (e.g., stress, fatigue or multi-tasking). The objective of the study was to examine the role of verbal guidance during laparoscopic skills training, asking whether a minor adaptation of the traditional Halstedian apprenticeship approach to laparoscopic training (absence of verbal guidance) allows similar advantages to accrue. Methods: We trained 14 volunteers (M age = 23.43 years: 10 males) with no prior medical background to perform a laparoscopic suture with intracorporeal knot tie in a training box. All participants observed a standardized demonstration of the procedure performed by an expert surgeon (>500 laparoscopic procedures). For half of the participants the demonstration was accompanied by a running verbal commentary and the participants were provided verbal guidance when they practiced the procedure (Instructed-observation treatment condition). For the remaining participants the demonstration was not supported by a running commentary and no verbal guidance was provided when they practiced the procedure (Observation-only treatment condition). Participants observed the video demonstration before each practice trial and continued to practice until, on 3 consecutive trials, performance matched the surgeon. In a test phase, participants then completed a retention test (3 trials) and a multi-tasking test (3 trials). In the multi-tasking test the laparoscopic procedure was performed concurrently with a demanding cognitive task (random letter generation). Dependent measures were procedure completion time and number of hand movements (collected via the Imperial College Surgical Assessment Device). Results: Learners in the Observation-only treatment condition reached a level of proficiency comparable with the expert surgeon in less practice trials (M = 51.00, SD = 12.19) than learners in the Instructed-observation condition (M = 65.57, SD = 15.13, P = 0.07). Planned comparisons of the change in completion times from the retention test to the multi-tasking test (see left figure) showed a significant slowing of completion times in the Instructed-observation treatment condition (t6 = -3.12, P = 0.02), but not in the Observation-only treatment condition (t6 = -1.80, P = 0.12). Similarly, the number of hand movements needed to complete the procedure (see right figure) increased significantly during multi-tasking, in the Instructed-observation treatment condition (t6 = -2.91, P = 0.03), but not in the Observation-only condition (t6 = -1.85, P = 0.12). Conclusions: An absence of verbal guidance during practice accelerated learning of a laparoscopic procedure and culminated in performance that was robust against the demands of multi-tasking. The findings imply that surgical skills training may be more effective if verbal guidance about the movements that constitute the procedure is avoided.
DescriptionPoster presentation
Topic: Education
Program Number: P207
Fulltext of the abstract and poster in: http://www.sages.org/meetings/annual-meeting/abstracts-archive/the-impact-of-verbal-guidance-on-laparoscopic-skills-training-and-multi-tasking-performance/
Persistent Identifierhttp://hdl.handle.net/10722/127903

 

DC FieldValueLanguage
dc.contributor.authorPoolton, Jen_HK
dc.contributor.authorFan, Jen_HK
dc.contributor.authorMasters, RSen_HK
dc.contributor.authorPatil, NGen_HK
dc.contributor.authorLaw, WLen_HK
dc.date.accessioned2010-10-31T13:53:23Z-
dc.date.available2010-10-31T13:53:23Z-
dc.date.issued2010en_HK
dc.identifier.citationSAGES 2010, 12th World Congress of Endoscopic Surgery, Landover, Maryland, USA, 14-17 April 2010, p. P207en_HK
dc.identifier.urihttp://hdl.handle.net/10722/127903-
dc.descriptionPoster presentation-
dc.descriptionTopic: Education-
dc.descriptionProgram Number: P207-
dc.descriptionFulltext of the abstract and poster in: http://www.sages.org/meetings/annual-meeting/abstracts-archive/the-impact-of-verbal-guidance-on-laparoscopic-skills-training-and-multi-tasking-performance/-
dc.description.abstractIntroduction: Evidence from studies of implicit motor learning suggest that advantages accrue from discouraging the build up of verbal knowledge about the movements that constitute a skill. The advantages include performance that is impervious to demands present in challenging task environments (e.g., stress, fatigue or multi-tasking). The objective of the study was to examine the role of verbal guidance during laparoscopic skills training, asking whether a minor adaptation of the traditional Halstedian apprenticeship approach to laparoscopic training (absence of verbal guidance) allows similar advantages to accrue. Methods: We trained 14 volunteers (M age = 23.43 years: 10 males) with no prior medical background to perform a laparoscopic suture with intracorporeal knot tie in a training box. All participants observed a standardized demonstration of the procedure performed by an expert surgeon (>500 laparoscopic procedures). For half of the participants the demonstration was accompanied by a running verbal commentary and the participants were provided verbal guidance when they practiced the procedure (Instructed-observation treatment condition). For the remaining participants the demonstration was not supported by a running commentary and no verbal guidance was provided when they practiced the procedure (Observation-only treatment condition). Participants observed the video demonstration before each practice trial and continued to practice until, on 3 consecutive trials, performance matched the surgeon. In a test phase, participants then completed a retention test (3 trials) and a multi-tasking test (3 trials). In the multi-tasking test the laparoscopic procedure was performed concurrently with a demanding cognitive task (random letter generation). Dependent measures were procedure completion time and number of hand movements (collected via the Imperial College Surgical Assessment Device). Results: Learners in the Observation-only treatment condition reached a level of proficiency comparable with the expert surgeon in less practice trials (M = 51.00, SD = 12.19) than learners in the Instructed-observation condition (M = 65.57, SD = 15.13, P = 0.07). Planned comparisons of the change in completion times from the retention test to the multi-tasking test (see left figure) showed a significant slowing of completion times in the Instructed-observation treatment condition (t6 = -3.12, P = 0.02), but not in the Observation-only treatment condition (t6 = -1.80, P = 0.12). Similarly, the number of hand movements needed to complete the procedure (see right figure) increased significantly during multi-tasking, in the Instructed-observation treatment condition (t6 = -2.91, P = 0.03), but not in the Observation-only condition (t6 = -1.85, P = 0.12). Conclusions: An absence of verbal guidance during practice accelerated learning of a laparoscopic procedure and culminated in performance that was robust against the demands of multi-tasking. The findings imply that surgical skills training may be more effective if verbal guidance about the movements that constitute the procedure is avoided.-
dc.languageengen_HK
dc.publisherSociety of American Gastrointestinal and Endoscopic Surgeons (SAGES). The conference's web site is located at http://www.sages.org/-
dc.relation.ispartofSAGES, Scientific Session & Postgraduate Course-
dc.titleThe Impact of Verbal Guidance on Laparoscopic Skills Training and Multi-tasking Performanceen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailPoolton, J: jamiep@hku.hken_HK
dc.identifier.emailMasters, RS: mastersr@hku.hken_HK
dc.identifier.emailPatil, NG: ngpatil@hkucc.hku.hken_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.hkuros175044en_HK
dc.identifier.hkuros169257-
dc.identifier.spageP207-
dc.identifier.epageP207-
dc.publisher.placeUnited States-

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