Interval vs Massed Training: How Best Do We Teach Surgery?

Kesser, Bradley W.; Hallman, Matthew J; Murphy, Loren; Tillar, Maggie; Keeley, Meg; Peirce, Shayn M.

doi:10.1177/0194599813513712

Cited by 10 publications

(13 citation statements)

References 23 publications

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“…Further, just one of the educational studies on SBT of MT so far has been comparative (5), meaning that most simulation models and modalities have not been compared. Also, only a single study compared different instructional designs of SBT of MT (massed vs. interval training) and found no statistically significant difference in time to completion or errors (49). This contrasts other studies on skills acquisition of surgical procedures (66,67) including mastoidectomy (68) where distributed practice consistently has been found to be superior to massed practice.…”

Section: Discussionmentioning

confidence: 68%

“…In the studies that included assessment of performance (39)(40)(41)(42)(43)45,47,49,(51)(52)(53)(54)(55)59,60,62), different assessment methods and tools were used. These were mainly Global Rating Scales (GRS) where the rater for example assigns an overall score based on observation of the performance (39,41,42,45,(51)(52)(53)(54)(55)62);…”

Section: Performance Assessmentmentioning

confidence: 99%

“…Task-Based/Task-Specific Checklists where the rater for example checks if specific sub-tasks are performed or errors made (41,42,(51)(52)(53)55,62); and metrics such as time to completion of the procedure (39)(40)(41)(42)(43)45,49,(52)(53)(54)(55)60). Two studies used completely automated metrics derived from the VR simulators such as procedure time, contact with the external ear canal, number of attempts of tube insertion, etc.…”

Section: Performance Assessmentmentioning

confidence: 99%

“…Seven studies with different study designs included measurement of the effects of SBT on skills performance (42,43,45,49,(52)(53)(54), corresponding to Kirkpatrick level 2b outcomes, and a single recent study further examined transfer of skills to the operating room, corresponding to a level 3 outcome (62). One study found that SBT resulted in a significant improvement in overall performance of ORL trainees and experts on GRS (52), and another study demonstrated significant improvement in medical students' performance using GRS and Task-Based Checklists (54).…”

Section: Outcomes Of Simulation-based Trainingmentioning

confidence: 99%

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Current Evidence for Simulation-Based Training and Assessment of Myringotomy and Ventilation Tube Insertion: A Systematic Review

Hovgaard

Al-Shahrestani

Andersen

2021

Otology &Amp; Neurotology

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Objective: Myringotomy and ventilation tube insertion (MT) is a key procedure in otorhinolaryngology and can be trained using simulation models. We aimed to systematically review the literature on models for simulation-based training and assessment of MT and supporting educational evidence. Databases Reviewed: PubMed, Embase, Cochrane Library, Web of Science, Directory of Open Access Journals. Methods: Inclusion criteria were MT training and/or skills assessment using all types of training modalities and learners. Studies were divided into 1) descriptive and 2) educational interventional/observational in the analysis. For descriptive studies, we provide an overview of available models including materials and cost. Educational studies were appraised using Kirkpatrick's level of educational outcomes, Messick's framework of validity, and a structured quality assessment tool. Results: Forty-six studies were included consisting of 21 descriptive studies and 25 educational studies. Thirty-one unique physical and three virtual reality simulation models were identified. The studies report moderate to high realism of the different simulators and trainees and educators perceive them beneficial in training MT skills. Overall, simulation-based training is found to reduce procedure time and errors, and increase performance as measured using different assessment tools. None of the studies used a contemporary validity framework and the current educational evidence is limited. Conclusion: Numerous simulation models and assessment tools have been described in the literature but educational evidence and systematic implementation into training curricula is scarce. There is especially a need to establish the effect of simulation-based training of MT in transfer to the operating room and on patient outcomes.

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Section: Discussionmentioning

confidence: 68%

Section: Performance Assessmentmentioning

confidence: 99%

Section: Performance Assessmentmentioning

confidence: 99%

Section: Outcomes Of Simulation-based Trainingmentioning

confidence: 99%

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Current Evidence for Simulation-Based Training and Assessment of Myringotomy and Ventilation Tube Insertion: A Systematic Review

Hovgaard

Al-Shahrestani

Andersen

2021

Otology &Amp; Neurotology

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“…In reality, dissection training is often organized as short and intense courses; massed practice consistently leads to suboptimal skills acquisition, retention and transfer 41,55–57 . The positive effect of distributed practice can be attributed to time dependent consolidation of memory 57 and even for a simple procedure such as myringotomy, spacing practice by a single day is insufficient in improving novice performance 58 . Therefore, the increasingly popular “ORL surgical boot camps” 59,60 with simulation-based, massed practice of a range of surgical skills may have limited long term effectiveness for learning otologic skills.…”

Section: Introductionmentioning

confidence: 99%

Otologic Skills Training

Wiet

Sørensen

Andersen

2017

Otolaryngologic Clinics of North America

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Synopsis This review presents a summary of the current activity of simulation training for otologic skills. Simulation training has been demonstrated in a large spectrum of skills from simple otoscopy to advanced temporal bone surgical procedures and these are individually addressed. There is a wide variety of educational approaches, assessment tools and simulators in use including simple low cost task trainers to complex computer based virtual reality systems. A systematic approach to otologic skills training using adult learning theory concepts such as repeated and distributed practice, self-directed learning, and mastery learning is necessary for these educational interventions to be effective. Future directions include development of valid, universally accepted measures of performance to assess efficacy of simulation training interventions and for complex procedures, improvement in fidelity based on the educational goals for the particular skill.

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