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Does watching someone struggle help medical students learn surgery skills?

Dempsey MS, Kauffman DF · Frontiers in psychology · 2017

Open access · cc by · source: Europe PMC

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.

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

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Key findings

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.

Methodology

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.

Limitations

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.

How this study connects

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