Randomized double-blinded trial investigating the impact of a curriculum focused on error recognition on laparoscopic suturing training

Bingener, Juliane; Boyd, Tanner; Van Sickle, Kent; Jung, Inkyung; Saha, Arup; Winston, John; Lopez, Peter; Ojeda, Herminio; Schwesinger, Wayne; Anastakis, Dimitri

doi:10.1016/j.amjsurg.2007.11.001

« Previous Next »The American Journal of Surgery
Volume 195, Issue 2 , Pages 179-182, February 2008

Randomized double-blinded trial investigating the impact of a curriculum focused on error recognition on laparoscopic suturing training

Presented at the Association for Surgical Education, April 11, 2007, Washington, DC

Juliane Bingener, M.D.
- Department of Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., MC 7842, San Antonio, TX 78229, USA
- Corresponding author. Tel.: +1-210-567-5730; fax: +1-210-567-5797.
Tanner Boyd, B.S.
- Department of Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., MC 7842, San Antonio, TX 78229, USA
Kent Van Sickle, M.D.
- Department of Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., MC 7842, San Antonio, TX 78229, USA
Inkyung Jung, M.D.
- Department of Biostatistics and Epidemiology, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
Arup Saha, M.D.
- Department of Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., MC 7842, San Antonio, TX 78229, USA
John Winston, M.D.
- Department of Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., MC 7842, San Antonio, TX 78229, USA
Peter Lopez, M.D.
- Department of Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., MC 7842, San Antonio, TX 78229, USA
Herminio Ojeda, M.D.
- Department of Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., MC 7842, San Antonio, TX 78229, USA
Wayne Schwesinger, M.D.
- Department of Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Dr., MC 7842, San Antonio, TX 78229, USA
Dimitri Anastakis, M.D.
- Department of Surgery, University of Toronto, Toronto, Canada

Received 24 April 2007; received in revised form 5 November 2007 published online 21 December 2007.

Abstract

Background

Error recognition predicts technical skill. A curriculum including error recognition may improve laparoscopic suturing performance.

Methods

Thirty novices were randomized into 2 groups. Each viewed an instruction videotape and underwent timed objective structured assessments of technical skills. Group A practiced the task, group B viewed an error-instruction video, practiced, followed by re-assessment. Participants counted errors on a videotape. Data were analyzed with the Fisher exact text, the Wilcoxon test, and the Kendall tau test.

Results

The improvement in task time was greater in group A than in group B (P < .001). The objective structured assessments of technical skills scores improved for both groups, but did not reveal differences between the groups. Group B recognized significantly more errors than group A (P < 0.001).

Conclusions

The additional error instruction showed a negative impact on performance speed, but improved cognitive error recognition. Whether visual memory overload influenced the outcome requires further examination

Keywords: Laparoscopy, Laparoscopic suturing, Skills training, Error recognition, Curriculum