RESUMEN

Reading numbers aloud, a central aspect of numerical literacy, is a challenging skill to acquire, but the origins of this difficulty remain poorly understood. To investigate this matter, we examined the performance of 127 third- and fourth-grade children who read aloud, in Hebrew, numbers with 2-5 digits. We found several key observations. First, we observed a substantial variation among the 3rd graders-7% and 59% errors in the top and bottom deciles, respectively. Second, the task difficulty stemmed from syntactic processing: Most errors were distortions of the number's syntax, as opposed to digit substitutions or transpositions, and the main factor affecting a specific number's difficulty was not its magnitude, as is commonly assumed, but rather its syntactic structure. Third, number reading performance was not predicted by a school-like task that assessed syntactic-conceptual knowledge of the decimal system structure, but rather by knowledge of specific syntactic-verbal rules, suggesting that the syntactic-verbal knowledge is separate from the syntactic-conceptual knowledge. Last, there was a double dissociation between 4-digit numbers and 5-digit numbers, which in Hebrew have completely different syntactic structures: Half of the children showed a significant advantage in one number length compared to the other, with equal numbers of children preferring either length. This indicates that the different syntactic-verbal rules are learned relatively independently of each other, with little or no generalization from one rule to another. In light of these findings, we propose that schools should specifically teach number reading, with focus on specific syntactic-verbal rules.

Asunto(s)

RESUMEN

Introduction: Online learning has changed the educational environment and may influence the development of nursing skills, mastery, and competence in students. Objective: The study aimed to investigate how nursing students acquire procedural skills, achieve mastery, and build competence through online learning, considering the growing use of technology in healthcare education. Methods: This study utilized a qualitative descriptive research approach to investigate the experiences of 32 nursing students from the Nursing Department who had undergone online procedural learning. Semistructured interviews were conducted to collect in-depth insights. Purposive sampling was used to gather data with a profound understanding of the phenomenon. The data analysis encompassed a methodical content analysis coding procedure. Independent researchers reviewed the results to validate the findings. Results: Content analysis of the data identified three key themes: achieving nursing procedural knowledge through online learning, achieving nursing procedural skills with the power of online learning, and gaining procedural competence through online social and collaborative learning. Conclusions: Online learning played a significant role in shaping and enhancing nursing procedural knowledge, skills, and competence, emphasizing the importance of integrating technology training modules and staying updated with emerging technologies.

RESUMEN

Developing both conceptual and procedural knowledge is important for students' mathematics competence. This study examined whether Grade 9 general education mathematics teachers' self-reported use of concept-focused instruction (CFI) and procedure-focused instruction (PFI) were associated differently with ninth graders' algebra achievement after 2.5 years, depending on students' mathematics difficulty (MD) status. Data for this study were drawn from the High School Longitudinal Study for the years 2009-2010 and 2011-2012 (N = 19,104). Multiple regression analyses indicated that students with MD who participated in Grade 9 mathematics classrooms where teachers self-reported the use of less CFI and more PFI were more positively associated with having higher algebra achievement after 2.5 years. Conversely, students without MD in classrooms where mathematics teachers self-reported the use of more CFI and less PFI were positively associated with having higher algebra achievement after 2.5 years. However, this study's findings do not suggest that teachers should disregard CFI and provide only PFI when teaching students with MD. Because the data set did not include any variable to discover whether teachers provided sufficient support (i.e., evidence-based practices) for students with MD, who have more constraints in their cognitive skills compared to students without MD, to benefit from CFI, the findings of this study should be interpreted cautiously. Directions for future research and practical implications are discussed.

RESUMEN

Even though past research suggests that visual learning may benefit from conceptual knowledge, current interventions for medical image evaluation often focus on procedural knowledge, mainly by teaching classification algorithms. We compared the efficacy of pure procedural knowledge (three-point checklist for evaluating skin lesions) versus combined procedural plus conceptual knowledge (histological explanations for each of the three points). All students then trained their classification skills with a visual learning resource that included images of two types of pigmented skin lesions: benign nevi and malignant melanomas. Both treatments produced significant and long-lasting effects on diagnostic accuracy in transfer tasks. However, only students in the combined procedural plus conceptual knowledge condition significantly improved their diagnostic performance in classifying lesions they had seen before in the pre- and post-tests. Findings suggest that the provision of additional conceptual knowledge supported error correction mechanisms.

RESUMEN

BACKGROUND: Situational judgement test (SJT) scores have been observed to predict actual workplace performance. They are commonly used to assess non-academic attributes as part of selection into many healthcare roles. However, no validated SJT yet exists for recruiting into mental health services. AIMS: To develop and validate an SJT that can evaluate procedural knowledge of professionalism in applicants to clinical roles in mental health services. METHOD: SJT item content was generated through interviews and focus groups with 56 professionals, patients and carers related to a large National Health Service mental health trust in England. These subject matter experts informed the content of the final items for the SJT. The SJT was completed by 73 registered nurses and 36 allied health professionals (AHPs). The primary outcome measure was supervisor ratings of professionalism and effectiveness on a relative percentile rating scale and was present for 69 of the participating nurses and AHPs. Personality assessment scores were reported as a secondary outcome. RESULTS: SJT scores statistically significantly predicted ratings of professionalism (ß = 0.31, P = 0.01) and effectiveness (ß = 0.32, P = 0.01). The scores demonstrated statistically significant incremental predictive validity over the personality assessment scores for predicting supervisor ratings of professionalism (ß = 0.26, P = 0.03). CONCLUSIONS: These findings demonstrate that a carefully designed SJT can validly assess important personal attributes in clinicians working in mental health services. Such assessments are likely to represent evidence based, cost-effective tools that can support values-based recruitment to mental health service roles.

RESUMEN

El propósito de este estudio fue diseñar y validar un instrumento para la evaluación del conocimiento declarativo y procedimental en un deporte de invasión como el baloncesto en el contexto escolar. En el proceso de validación participaron 15 jueces expertos. El instrumento estuvo formado por 34 ítems distribuidos en dos bloques, declarativo y procedimental. Responde al siguiente tipo de preguntas: ¿Qué es?, ¿Sirve para?, ¿Qué se consigue?, ¿Cuál es? y ¿Cómo se realiza? La validez de contenido se calculó mediante el coeficiente V de Aiken y sus intervalos de confianza. Para la consistencia interna se empleó el coeficiente α de Cronbach. Ninguna de las preguntas que componen el test de conocimiento declarativo y procedimental fue eliminada al superar el valor crítico exacto (V≥.74). La consistencia interna de las preguntas fue excelente (α=.95). Por tanto, el instrumento es válido y fiable para la evaluación del conocimiento en el baloncesto escolar. (AU)

The purpose of this study has been the design and validation of an instrument for the evaluation of declarative and procedural knowledge in an invasion sport such as basketball in the school context. 15 expert judges participated in the validation process. The instrument consisted of 34 items distributed in two blocks, declarative and procedural. Answers the following type of questions: Is it useful for?, What is it ?, What is achieved ?, Which one is it? In addition, how is it done? Content validity was calculated using Aiken's V coefficient and its confidence intervals. Cronbach's α coefficient was used for internal consistency. None of the questions that make up the declarative and procedural knowledge test were eliminated by exceeding the exact critical value (V≥.74). The internal consistency of the questions was excellent (α=.95). Therefore, the instrument is valid and reliable for the evaluation of knowledge in school basketball. (AU)

Asunto(s)

RESUMEN

Cognitive arithmetic classically distinguishes procedural and conceptual knowledge as two determinants of the acquisition of flexible expertise. Whereas procedural knowledge relates to algorithmic routines, conceptual knowledge is defined as the knowledge of core principles, referred to as fundamental structures of arithmetic. To date, there is no consensus regarding their number, list, or even their definition, partly because they are difficult to measure. Recent findings suggest that among the most complex of these principles, some might not be "fundamental structures" but rather may articulate several components of conceptual knowledge, each specific to the arithmetic operation involved. Here, we argue that most of the arithmetic principles similarly may rather articulate several core concepts specific to the operation involved. Data were collected during a national mathematics contest based on an arithmetic game involving a large sample of 9- to 11-year-old students (N = 11,243; 53.1% boys) over several weeks. The purpose of the game was to solve complex arithmetic problems using five numbers and the four operations. A principal component analysis (PCA) was performed. The results show that both conceptual and procedural knowledge were used by children. Moreover, the PCA sorted conceptual and procedural knowledge together, with dimensions being defined by the operation rather than by the concept. This implies that "fundamental structures" rather regroup different concepts that are learned separately. This opens the way to reconsider the very nature of conceptual knowledge and has direct pedagogical implications.

Asunto(s)

RESUMEN

Procedural knowledge space theory (PKST) was recently proposed by Stefanutti (British Journal of Mathematical and Statistical Psychology, 72(2) 185-218, 2019) for the assessment of human problem-solving skills. In PKST, the problem space formally represents how a family of problems can be solved and the knowledge space represents the skills required for solving those problems. The Markov solution process model (MSPM) by Stefanutti et al. (Journal of Mathematical Psychology, 103, 102552, 2021) provides a probabilistic framework for modeling the solution process of a task, via PKST. In this article, three adaptive procedures for the assessment of problem-solving skills are proposed that are based on the MSPM. Beside execution correctness, they also consider the sequence of moves observed in the solution of a problem with the aim of increasing efficiency and accuracy of assessments. The three procedures differ from one another in the assumption underlying the solution process, named pre-planning, interim-planning, and mixed-planning. In two simulation studies, the three adaptive procedures have been compared to one another and to the continuous Markov procedure (CMP) by Doignon and Falmagne (1988a). The last one accounts for dichotomous correct/wrong answers only. Results show that all the MSP-based adaptive procedures outperform the CMP in both accuracy and efficiency. These results have been obtained in the framework of the Tower of London test but the procedures can also be applied to all psychological and neuropsychological tests that have a problem space. Thus, the adaptive procedures presented in this paper pave the way to the adaptive assessment in the area of neuropsychological tests.

Asunto(s)

RESUMEN

The automatic extraction of procedural surgical knowledge from surgery manuals, academic papers or other high-quality textual resources, is of the utmost importance to develop knowledge-based clinical decision support systems, to automatically execute some procedure's step or to summarize the procedural information, spread throughout the texts, in a structured form usable as a study resource by medical students. In this work, we propose a first benchmark on extracting detailed surgical actions from available intervention procedure textbooks and papers. We frame the problem as a Semantic Role Labeling task. Exploiting a manually annotated dataset, we apply different Transformer-based information extraction methods. Starting from RoBERTa and BioMedRoBERTa pre-trained language models, we first investigate a zero-shot scenario and compare the obtained results with a full fine-tuning setting. We then introduce a new ad-hoc surgical language model, named SurgicBERTa, pre-trained on a large collection of surgical materials, and we compare it with the previous ones. In the assessment, we explore different dataset splits (one in-domain and two out-of-domain) and we investigate also the effectiveness of the approach in a few-shot learning scenario. Performance is evaluated on three correlated sub-tasks: predicate disambiguation, semantic argument disambiguation and predicate-argument disambiguation. Results show that the fine-tuning of a pre-trained domain-specific language model achieves the highest performance on all splits and on all sub-tasks. All models are publicly released.

Asunto(s)

RESUMEN

Does the Ebbinghaus visual illusion really influence sports performances? Does the influence depend on the type of knowledge (procedural vs. declarative) that guides movement? To address these questions, we evaluated the knowledge hypothesis, a novel hypothesis according to which the more sports performance relies on procedural knowledge, the more it will be influenced by visual illusions. In the context of golf putting, we first used the high-error/low-error motor-learning technique (Experiment 1) or varied the number of practice trials (Experiment 2) to induce novice participants to rely more on procedural knowledge than on declarative knowledge (or vice versa). We then manipulated the perceived size of two golf holes by projecting a ring of small or large circles around them, which caused the holes to appear larger or smaller, respectively. This Ebbinghaus visual illusion had an influence on putting in both experiments. We also observed a pattern of findings consistent with the knowledge hypothesis: the procedural groups were moderately influenced by the illusion when putting, but the declarative groups were influenced only weakly, at best. Among the participants most sensitive to the illusion, the analyses confirmed a significantly stronger influence for the procedural group. Overall, these findings demonstrate that the effect of visual illusions on sports performance is a reliable phenomenon for proceduralized actions. The knowledge hypothesis represents an attractive way of reconciling earlier divergent findings.

Asunto(s)

RESUMEN

BACKGROUND: The flipped skills lab is a student-centred approach which incorporates pre-class preparation (pre-skill conceptualization) followed by repeated, hands-on practice for practical skills training. Objective measures of skills acquisition in the flipped literature are few and conflicting. The importance of pre-skill conceptualization in flipped skills training suggests that pedagogically informed pre-skill conceptualization can enhance outcomes. METHODS: A mixed quasi-experimental study was conducted on 41 final year medical students who followed a flipped newborn resuscitation skills lab. Pre-class preparatory material covered conceptual and procedural knowledge. Students in the traditional group (n = 19) and those in the interventionalmental group (n = 22) received identical reading material covering conceptual knowledge. Procedural knowledge was shared with the interventional group as demonstration videos, while the traditional group received a PowerPoint presentation with text and images covering the same material. Knowledge acquisition was assessed by 20 single best answer questions before and after hands-on practice in the skills lab and skill performance was tested post-intervention with a simulated scenario. Students' perceptions were collected by survey. Quantitative data was analysed using Wilcoxon Signed Ranks test and Mann-Whitney U test as appropriate. Qualitative data was analysed by thematic analysis. RESULTS: Overall student rating of the intervention was positive with ratings of 4.54 and 4.46 out of 5 by the traditional group and the experimental group respectively. Post-intervention skill performance in the experimental group was significantly better (p < .05) in the interventional group (M = 87.86%, SD = 5.89) than in the traditional group (M = 83.44, SD = 5.30) with a medium effect size (r = .40). While both groups showed significant knowledge gains, only students in the experimental group showed a statistically significant gain in procedural knowledge (p < .05) following the flipped skills lab. Finally, while both groups self-reported feeling more knowledgeable and confident following the intervention, the level of confidence was superior in the experimental group. CONCLUSIONS: Flipping the skills lab with pre-skill conceptualisation combining text-based conceptual knowledge and video-based procedural knowledge followed by simulation-based hands-on practice improves procedural knowledge and skills acquisition in newborn resuscitation training for medical students. This study shows that in addition to temporal benefits, pedagogically informed pre-skill conceptualization can confer procedure-specific cognitive and emotional benefits supporting skills acquisition.

Asunto(s)

RESUMEN

Surgical simulation practices have witnessed a rapid expansion as an invaluable approach to resident training in recent years. One emerging way of implementing simulation is the adoption of extended reality (XR) technologies, which enable trainees to hone their skills by allowing interaction with virtual 3D objects placed in either real-world imagery or virtual environments. The goal of the present systematic review is to survey and broach the topic of XR in neurosurgery, with a focus on education. Five databases were investigated, leading to the inclusion of 31 studies after a thorough reviewing process. Focusing on user performance (UP) and user experience (UX), the body of evidence provided by these 31 studies showed that this technology has, in fact, the potential of enhancing neurosurgical education through the use of a wide array of both objective and subjective metrics. Recent research on the topic has so far produced solid results, particularly showing improvements in young residents, compared to other groups and over time. In conclusion, this review not only aids to a better understanding of the use of XR in neurosurgical education, but also highlights the areas where further research is entailed while also providing valuable insight into future applications.

Asunto(s)

RESUMEN

BACKGROUND: Surgical training is primarily carried out through observation during assistance or on-site classes, by watching videos as well as by different formats of simulation. The simulation of physical presence in the operating theatre in virtual reality might complement these necessary experiences. A prerequisite is a new education concept for virtual classes that communicates the unique workflows and decision-making paths of surgical health professions (i.e. surgeons, anesthesiologists and surgical assistants) in an authentic and immersive way. For this project, media scientists, designers and surgeons worked together to develop the foundations for new ways of conveying knowledge using virtual reality in surgery. MATERIALS AND METHOD: A technical workflow to record and present volumetric videos of surgical interventions in a photorealistic virtual operating room was developed. Situated in the virtual reality demonstrator called VolumetricOR, users can experience and navigate through surgical workflows as if they are physically present. The concept is compared with traditional video-based formats of digital simulation in surgical training. RESULTS: VolumetricOR let trainees experience surgical action and workflows (a) three-dimensionally, (b) from any perspective and (c) in real scale. This improves the linking of theoretical expertise and practical application of knowledge and shifts the learning experience from observation to participation. DISCUSSION: Volumetric training environments allow trainees to acquire procedural knowledge before going to the operating room and could improve the efficiency and quality of the learning and training process for professional staff by communicating techniques and workflows when the possibilities of training on-site are limited.

Asunto(s)

RESUMEN

Introduction: In healthcare organizations, saving patients' lives while maintaining the staff's wellbeing, performance and competencies were challenging during the COVID-19 pandemic. Although the complexity of healthcare settings is widely recognized, the pandemic evidenced the necessity of attending to the employees' wellbeing in such a sector. This research aims to examine the effect of sustainable leadership on wellbeing of healthcare personnel. Furthermore, we also evaluate whether procedural knowledge and compassion act as mediators in such a relationship. Methods: The hypothesized model was tested in healthcare organizations in a South Asian country, and the data were collected during the pandemic crisis. A total of 366 health personnel (physicians and nurses) participated in this research. With Hayes' PROCESS macro, we examined all the direct and indirect paths, including sequential mediation. Results: The findings confirm the impact of sustainable leadership on wellbeing and this relationship is also mediated by procedural knowledge and compassion. Discussion/conclusion: Sustainable leadership fosters wellbeing among healthcare workers via the sequential mediation of procedural knowledge and compassion. Study findings suggest that sustainable leaders can trigger procedural knowledge among employees which in turn crafts the state of compassion in them that leads to their wellbeing. Theoretical and practical implications are discussed in light of study findings.

RESUMEN

When, how, and why students use conceptual knowledge during math problem solving is not well understood. We propose that when solving routine problems, students are more likely to recruit conceptual knowledge if their procedural knowledge is weak than if it is strong, and that in this context, metacognitive processes, specifically feelings of doubt, mediate interactions between procedural and conceptual knowledge. To test these hypotheses, in two studies (Ns = 64 and 138), university students solved fraction and decimal arithmetic problems while thinking aloud; verbal protocols and written work were coded for overt uses of conceptual knowledge and displays of doubt. Consistent with the hypotheses, use of conceptual knowledge during calculation was not significantly positively associated with accuracy, but was positively associated with displays of doubt, which were negatively associated with accuracy. In Study 1, participants also explained solutions to rational arithmetic problems; using conceptual knowledge in this context was positively correlated with calculation accuracy, but only among participants who did not use conceptual knowledge during calculation, suggesting that the correlation did not reflect "online" effects of using conceptual knowledge. In Study 2, participants also completed a nonroutine problem-solving task; displays of doubt on this task were positively associated with accuracy, suggesting that metacognitive processes play different roles when solving routine and nonroutine problems. We discuss implications of the results regarding interactions between procedural knowledge, conceptual knowledge, and metacognitive processes in math problem solving.

Asunto(s)

RESUMEN

Syntactic priming (SP) is the effect by which, in a dialogue, the current speaker tends to re-use the syntactic constructs of the previous speakers. SP has been used as a window into the nature of syntactic representations within and across languages. Because of its importance, it is crucial to understand the mechanisms behind it. Currently, two competing theories exist. According to the transient activation account, SP is driven by the re-activation of declarative memory structures that encode structures. According to the error-based implicit learning account, SP is driven by prediction errors while processing sentences. By integrating both transient activation and associative learning, Reitter et al.'s hybrid model 2011 assumes that SP is achieved by both mechanisms, and predicts a priming enhancement for rare or unusual constructions. Finally, a recently proposed account, the reinforcement learning account, claims that SP driven by the successful application of procedural knowledge will be reversed when the prime sentence includes grammatical errors. These theories make different assumptions about the representation of syntactic rules (declarative vs. procedural) and the nature of the mechanism that drives priming (frequency and repetition, attention, and feedback signals, respectively). To distinguish between these theories, they were all implemented as computational models in the ACT-R cognitive architecture, and their specific predictions were examined through grid-search computer simulations. Two experiments were then carried out to empirically test the central prediction of each theory as well as the individual fits of each participant's responses to different parameterizations of each model. The first experiment produced results that were best explained by the associative account, but could also be accounted for by a modified reinforcement model with a different parsing algorithm. The second experiment, whose stimuli were designed to avoid the parsing ambiguity of the first, produced somewhat weaker effects. Its results, however, were also best predicted by the model implementing the associative account. We conclude that the data overall points to SP being due to prediction violations that direct attentional resources, in turn suggesting a declarative rather than a RL based procedural representation of syntactic rules.

RESUMEN

Exposure to task-irrelevant feedback leads to perceptual learning, but its effect on motor learning has been understudied. Here, we asked human participants to reach a visual target with a hand-controlled cursor while observing another cursor moving independently in a different direction. Although the task-irrelevant feedback did not change the main task's performance, it elicited robust savings in subsequent adaptation to classical visuomotor rotation perturbation. We demonstrated that the saving effect resulted from a faster formation of strategic learning through a series of experiments, not from gains in the implicit learning process. Furthermore, the saving effect was robust against drastic changes in stimulus features (i.e., rotation size or direction) or task types (i.e., for motor adaptation and skill learning). However, the effect was absent when the task-irrelevant feedback did not carry the visuomotor relationship embedded in visuomotor rotation. Thus, though previous research on perceptual learning has related task-irrelevant feedback to changes in early sensory processes, our findings support its role in acquiring abstract sensorimotor knowledge during motor learning. Motor learning studies have traditionally focused on task-relevant feedback, but our study extends the scope of feedback processes and sheds new light on the dichotomy of explicit and implicit learning in motor adaptation and motor structure learning.NEW & NOTEWORTHY When the motor system faces perturbations, such as fatigue or new environmental changes, it adapts to these changes by voluntarily selecting new action plans or implicitly fine-tuning the control. We show that the action selection part can be enhanced without practice or explicit instruction. We further demonstrate that this enhancement is probably linked to the acquisition of abstract knowledge about the to-be-adapted novel visual feedback. Our findings draw an interesting parallel between motor and perceptual learning by showing that top-down information affects both types of procedural learning.

Asunto(s)

RESUMEN

In this study, 17 adult participants were trained to solve alphabet-arithmetic problems using a production task (e.g., C + 3 = ?). The evolution of their performance across 12 practice sessions was compared with the results obtained in past studies using verification tasks (e.g., is C + 3 = F correct?). We show that, irrespective of the experimental paradigm used, there is no evidence for a shift from counting to retrieval during training. However, and again regardless of the paradigm, problems with the largest addend constitute an exception to the general pattern of results obtained. Contrary to other problems, their answers seem to be deliberately memorised by participants relatively early during training. All in all, we conclude that verification and production tasks lead to similar patterns of results, which can therefore both confidently be used to discuss current theories of learning. Still, deliberate memorization of problems with the largest addend appears earlier and more often in a production than a verification task. This last result is discussed in light of retrieval models.

Asunto(s)

RESUMEN

PURPOSE: The automatic extraction of knowledge about intervention execution from surgical manuals would be of the utmost importance to develop expert surgical systems and assistants. In this work we assess the feasibility of automatically identifying the sentences of a surgical intervention text containing procedural information, a subtask of the broader goal of extracting intervention workflows from surgical manuals. METHODS: We frame the problem as a binary classification task. We first introduce a new public dataset of 1958 sentences from robotic surgery texts, manually annotated as procedural or non-procedural. We then apply different classification methods, from classical machine learning algorithms, to more recent neural-network approaches and classification methods exploiting transformers (e.g., BERT, ClinicalBERT). We also analyze the benefits of applying balancing techniques to the dataset. RESULTS: The architectures based on neural-networks fed with FastText's embeddings and the one based on ClinicalBERT outperform all the tested methods, empirically confirming the feasibility of the task. Adopting balancing techniques does not lead to substantial improvements in classification. CONCLUSION: This is the first work experimenting with machine / deep learning algorithms for automatically identifying procedural sentences in surgical texts. It also introduces the first public dataset that can be used for benchmarking different classification methods for the task.

Asunto(s)

RESUMEN

OBJECTIVE: In surgery residency programs, Accreditation Council for Graduate Medical Education mandated performance assessment can include assessment in the operating room to demonstrate that necessary quality and autonomy goals are achieved by the conclusion of training. For the past 3 years, our institution has used The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) instrument to assess and track operative skills. Evaluation is accomplished in near real-time using a secure web-based platform for data management and analytics (Firefly). Simultaneous to access of the platform's case logging function, the O-SCORE instrument is delivered to faculty members for rapid completion, facilitating quality, and timeliness of feedback. We sought to demonstrate the platform's utility in detecting operative performance changes over time in response to focused educational interventions based on stored case log and O-SCORE data. DESIGN: Stored resident performance assessments for the most frequently performed laparoscopic procedures (cholecystectomy, appendectomy, inguinal hernia repair, ventral hernia repair) were examined for 3 successive academic years (2016-2019). During this time, 4 of 36 residents had received program-assigned supplemental simulation training to improve laparoscopic skills. O-SCORE data for these residents were extracted from peer data, which were used for comparisons. Assigned training consisted of a range of videoscopic and virtual reality skills drills with performance objectives. O-SCORE responses were converted to integers and autonomy scores for items pertaining to technical skill were compared before and after educational interventions (Student's t-tests). These scores were also compared to aggregate scores in the nonintervention group. Bayesian-modeled learning curves were used to characterize patterns of improvement over time. SETTING: University of Massachusetts Medical School-Baystate Surgery Residency and Baystate Medical Center PARTICIPANTS: General surgery residents (n = 36) RESULTS: During the period of review, 3325 resident cases were identified meeting the case type criteria. As expected, overall autonomy increased with the number of cases performed. The 4 residents who had been assigned supplemental training (6-18 months) had preintervention score averages that were lower than that of the nonintervention group (2.25 ± 0.43 vs 3.57 ± 1.02; p < 0.0001). During the respective intervention periods, all 4 residents improved autonomy scores (increase to 3.40 ± 0.61; p < 0.0001). Similar improvements were observed for tissue handling, instrument handling, bimanual dexterity, visuospatial skill, and operative efficiency component skills. Postintervention scores were not significantly different compared to scores for the non-intervention group. Bayesian-modeled learning curves showed a similar pattern of postintervention performance improvement. CONCLUSIONS: The data management platform proved to be an effective tool to track responses to supplemental training that was deemed necessary to close defined skills gaps in laparoscopic surgery. This could be seen both in individual and in aggregated data. We were gratified that at the conclusion of the supplemental training, O-SCORE results for the intervention group were not different than those seen in the non-intervention group.

Asunto(s)