WTP6.11 Are surgical technical errors inherited from lack of mental cognitive framework or lack of motor skills for a given surgical task? results of a pilot study

Abstract

Abstract Aims To study the impact of augmented terminal feedback designed by error type learning for developing surgical skill. Methods Twenty medical students were randomised in two groups, based on feedback they received; Video Feedback (VF) and Online Feedback (OF). Laparoscopic double square knot was selected as the task. Task was divided into subtasks and steps. Potential errors were studied and divided into types: Cognitive Based (CB) & Skill Based (SB). Laparoscopic Task was executed in four stages and feedback was provided after each stage. Error types and numbers were studied. Results 9178 errors were studied in 80 tasks, 320 subtasks and 2080 steps in four stages. 5091 (55%) CB errors and 4087 (45%) SB errors were recorded. VF group enacted 2251 CB errors in stages (46%,29%, 18%,7%) and 1692 SB errors (41%, 28%, 18%, 13%). OF group enacted 2840 CB errors (29%, 26%, 25%, 20%): whereas, 2396 SB errors (22%, 23%, 21%, 34%). Both groups were comparable in enacting SB & CB errors in early stage of skill; nevertheless, highly significant difference was noted in 3 stages when SB errors are considered (p < 0.01 vs OF group). Although, there was steady improvement in CB type errors, but no significant different was noted (p > 0.5 vs OF group) in all stages of learning. Conclusions Augmented terminal feedback in the form of videos feedback is superior to current standards in terms of reducing cognitive based errors; whereas, skill based errors rely on time and experience rather than type of feedback.