Does watching someone struggle help medical students learn surgery skills?
Students who watched an instructor make and recover from mistakes, and who got feedback on their process, tied surgical knots faster and felt more confident than those who saw a flawless demo with only outcome feedback.
Source
Supporting Third Year Medical Students' Skill Acquisition and Self-Efficacy with Coping Models and Process Feedback during Laparoscopic Knot Tying Simulation
Study at a glance
- Design
- Human experiment — 2x2 between-subjects factorial (coping vs mastery model x process vs outcome feedback) during a single laparoscopic knot-tying training session, plus short interviews with a subset.
- N
- N=78 · 78 third-year medical students randomised across the cells of a 2x2 design; 8 of them (two per group) interviewed afterwards.
- Population
- Third-year medical students on a surgical clerkship in the US
- Outcome
- Knot-tying time, satisfaction with performance, and self-efficacy (0-100 confidence ratings) before and after training
Structured fields used in claim comparison tables when every cited study has a complete layer.
What they did
78 medical students were randomly assigned to watch an instructor demonstrate laparoscopic knot tying either flawlessly (mastery model) or with deliberate early mistakes and self-talk (coping model). During 10 minutes of practice they then got either process feedback (what they did well and what to work on) or outcome feedback (only how many knots they had tied). Self-efficacy was rated before and after, and a subset of eight students was interviewed.
What they found
Modeling and feedback interacted: process feedback shortened knot-tying time, but only for students who had seen the coping model. The group that saw the mastery model and got outcome feedback had lower post-training self-efficacy than the other three groups. Students who saw the coping model reported more satisfaction with their performance, and interviewees said seeing the instructor drop the needle helped them persist.
The limits
What it doesn't show
Despite randomisation, groups differed in self-efficacy before training (the outcome-feedback groups started higher), which complicates the post-test comparisons. Some reported effect sizes are implausibly large and group means are only given in tables not included here, so the precise size of effects is hard to judge. The single short session in a simulation lab, with multiple instructors, says nothing about retention or performance on real patients.
Key terms
- Self-efficacy
- A person's belief in their ability to perform a specific task to a given standard.
- Coping model
- A demonstrator who struggles at first and then overcomes errors through effort and self-talk.
- Mastery model
- A demonstrator who performs the task smoothly and flawlessly from the start.
- Process feedback
- Feedback about how a learner is doing the task, what is working and what to improve, rather than just the result.
- Factorial design
- An experiment that crosses two or more manipulated factors so their separate and combined (interaction) effects can be tested.
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Quiz yourself
What kind of design did the study use?
Common questions
Why would watching a struggling instructor help more than a perfect one?
Seeing someone make and fix errors shows learners that mistakes are normal and recoverable, which can raise their confidence and keep them persisting when they slip up.
Is this a strong test of coping models?
It is a randomised experiment, but the sample was modest, groups differed at baseline, and outcomes were measured only immediately after one session.
What does the interaction mean here?
The benefit of process feedback on speed depended on which model students had watched: it appeared with the coping model but not the mastery model.
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