196: Limited feedback and video tutorials optimize learning and resource utilization during laparoscopic simulator training

Abstract

Introduction: Performance feedback is essential for learning motor skills but optimal methods have not been defined for simulator-based training. Video tutorials may facilitate skill acquisition. The purpose of this study was to determine the impact of instructor feedback and video tutorials on skill acquisition during proficiency-based laparoscopic suturing training. Methods: Performance data from a prospectively maintained database were reviewed for three groups of novices (n=34 medical students) who completed proficiency-based laparoscopic suturing training on a FLS-type videotrainer model as part of two separate IRB-approved randomized controlled trials. All trainees viewed a video tutorial, completed baseline testing and practiced during one-hour sessions to a previously validated proficiency level (score = 512) with standardized feedback provided by a single expert instructor. Group I (n=9) received intense feedback during the early stages of skill acquisition and had no further video exposure, Group II (n=13) received limited feedback (<10 min per session) and no further video exposure, and Group III (n=12) had limited feedback (<10 min. per session) and watched the video tutorial deliberately during each session. Feedback was quantified on a 0 (none) to 4 (extensive) Likert-scale per repetition by the instructor. Personnel and materials cost was calculated. Comparisons were by ANOVA; p<0.05 was considered significant. Results: Baseline performance was similar in all groups and all participants achieved the proficiency level on two consecutive attempts. As shown below, Group III required the shortest training time and resources to reach proficiency. Conclusions: Limited instructor feedback is superior to intense feedback during the early stages of proficiency-based laparoscopic simulator training. Coupled with video tutorials, this type of feedback may accelerate the learning curve and improve resource utilization by minimizing the need for instructor involvement. Tabled 1Group Comparison Group I (n=9) Group II (n=13) Group III (n=12) p-value (ANOVA) Instructor Feedback per Repetition † 0-4 Likert scale 1 ± 0.3 0.23 ± 0.1 0.27 ± 0.1 <0.001 ⁎ Pair-wise comparisons not significant between groups II and III Video Tutorial Viewings (#) 1 ± 0 1 ± 0 8 ± 1 <0.001 Training Time to Proficiency (min) 148 ± 52 112 ± 46 86 ± 30 <0.02 ⁎ Pair-wise comparisons not significant between groups II and III Repetitions to Proficiency (#) 50 ± 17 38 ± 13 31 ± 9 <0.02 ⁎ Pair-wise comparisons not significant between groups II and III Cost per trainee $156 ± 50 $51 ± 18 $43 ± 13 <0.001 ⁎ Pair-wise comparisons not significant between groups II and III † 0-4 Likert scale Pair-wise comparisons not significant between groups II and III Open table in a new tab