Perfectionistic Concerns are Detrimental to Skill Learning for Minimally Invasive Surgery

Abstract

The pursuit of high standards and continuous self-improvement are important aspects of a professional attitude in medicine. However, when identity and self-esteem are dependent on flawless performance, healthy striving can become perfectionism. The present study examines the influence of perfectionism on the learning process of basic instrument handling for minimally invasive surgery (MIS). Thirty medical students volunteered to participate in the study (19 females, 11 males). The mean age was 19.8 years (SD = 1.8). The Perfectionism Inventory was used to determine the degree of perfectionist characteristics in two main factors: Self-evaluative perfectionism and Conscientious perfectionism. Participants practiced with the loops and wire task on a surgical simulator and were tested for skill retention within 48 hours. During practice instrument movement was captured in three-dimensional space using a Leap Motion controller. Performance was assessed by time and total path length travelled by the instruments. Self-evaluative perfectionism was negatively related to skill retention with regard to movement efficiency, but did not predict change in average time on task. The Conscientious perfectionism factor was not a predictor of skill retention with regard to path length or completion time. Self-evaluative perfectionism was a significant predictor of change in average pathlength between sessions but did not predict change in average time. The Conscientious perfectionism factor was not a predictor of changes in path length or completion time. Overly negative self-evaluation during MIS skill practice undermined the learning process. Trainees with self-critical perfectionistic tendencies may not optimally benefit from their efforts during practice.