The relationship of praise/criticism to learning during obstetrical simulation: a randomized clinical trial

Abstract

The effect of positive vs. negative comments (praise vs. criticism) on trainees' subsequent cognitive and technical performance is unknown, but of potential importance. We performed a randomized trial of giving either praise or criticism during simulated normal vaginal deliveries (using a high-fidelity birthing simulator) to assess the differential effect of these types of comments on students' cognitive and technical performance, and perceived confidence after their learning experience. Medical and nursing students underwent stratified randomization to praise or criticism. Students (n=59) initially participated in a teaching demonstration and practiced normal spontaneous vaginal delivery using a birthing simulator. A baseline assessment of cognitive and technical skills, and of self-confidence, was followed by a second simulation during which positive or negative comments were given using standardized scripts. Cognitive performance, technical performance and confidence measures were then scored again. Cognitive and technical performance scores in the "praise" group improved significantly by 2.5 (P=0.007) and 1.8 (P=0.032), respectively, while those in the "criticism" group remained unchanged. The self-reported confidence scores did not show any significant change from baseline in either group. Praise strengthens students' cognitive and technical performances, while criticism does not.