Surgeons' and trainees' perceived self-efficacy in operating theatre non-technical skills

Pena, Guilherme; Altree, Meryl; Field, Jeff; Thomas, Matthew J. W.; Hewett, Peter; Babidge, Wendy; Maddern, Guy J.

doi:10.1002/bjs.9787

Cited by 19 publications

(14 citation statements)

References 23 publications

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“…Limitations include the use of self-reported measures of skills and mastery, because previous studies have found that these are often poorly correlated with observed skills, 54 and contextual factors, such as specialty, practice venues and other work-related factors, might be of importance for observed clinical performance among the doctors. By controlling for vulnerability, which resembles neuroticism, self-criticism and low self-esteem, we have adjusted for underestimating one’s own skills.…”

Section: Discussionmentioning

confidence: 99%

Medical school predictors of later perceived mastery of clinical work among Norwegian doctors: a cohort study with 10-year and 20-year follow-up

et al. 2017

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ObjectiveDoctors’ self-perceived mastery of clinical work might have an impact on their career and patient care, in addition to their own health and well-being. The aim of this study is to identify predictors at medical school of perceived mastery later in doctors’ careers.DesignA cohort of medical students (n=631) was surveyed in the final year of medical school in 1993/1994 (T1), and 10 (T2) and 20 (T3) years later.SettingNationwide healthcare institutions.ParticipantsMedical students from all universities in Norway.Main outcome measuresPerceived mastery of clinical work was measured at T2 and T3. The studied predictors measured at T1 included personality traits, medical school stress, perceived medical recording skills, identification with the role of doctor, hazardous drinking and drinking to cope, in addition to age and gender. Effects were studied using multiple linear regression models.ResultsResponse rates: T1, 522/631 (83%); T2, 390/522 (75%); and T3, 303/522 (58%). Mean scores at T2 and T3 were 22.3 (SD=4.2) and 24.5 (3.0) (t=8.2, p<0.001), with no gender difference. Adjusted associations at T2 were: role identification (β=0.16; p=0.006; 95% CI 0.05 to 0.28), perceived medical recording skills (β=0.13; p=0.02; 95% CI 0.02 to 0.24) and drinking to cope (β=–2.45; p=0.001; 95% CI –3.88 to –1.03). Adjusted association at T3 was perceived medical recording skills (β=0.11; p=0.015; 95% CI 0.02 to 0.21).ConclusionsPerceived medical recording skills and role identification were associated with higher perceived mastery. Medical schools should provide experiences, teaching and assessment to enhance students’ physician role identification and confidence in their own skills. Drinking to cope was associated with lower perceived mastery, which indicates the importance of acquiring healthier coping strategies in medical school.

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Section: Discussionmentioning

confidence: 99%

Medical school predictors of later perceived mastery of clinical work among Norwegian doctors: a cohort study with 10-year and 20-year follow-up

et al. 2017

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“…Secondary outcome measures include the differences between the control and intervention groups with respect to (1) procedural knowledge, as assessed by the knowledge MCQ tests; (2) NTS performance during the clinical colonoscopies, as assessed by the Modified Objective Structured Assessment of Non-Technical Skills (M-OSANTS) for colonoscopy, which has been previously validated for surgery and modified for endoscopy [ 4 ] ( Multimedia Appendix 5 ); (3) clinical performance on clinical colonoscopies, as assessed by the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT) [ 16 ] ( Multimedia Appendix 6 ); (4) technical performance on a VR simulated colonoscopy after training and 4 to 6 weeks after training (immediate and delayed post-training assessments, respectively), as assessed by the JAG DOPS and the GiECAT; (5) technical and non-technical performance during an integrated scenario format test 4 to 6 weeks after training, as assessed by the JAG DOPS, GiECAT, and M-OSANTS; (6) patient comfort during the clinical colonoscopies, as assessed by the Nurse-Assessed Patient Comfort Score (NAPCOMS) [ 17 ] ( Multimedia Appendix 7 ); (7) participant self-efficacy, as measured by an adapted scale based on the General Self-Efficacy Scale (GSE) [ 18 , 19 ] ( Multimedia Appendix 8 ); and (8) global performance and communication skills during integrated scenarios as assessed by the Integrated Scenario Global Rating Form (ISGRF) and Integrated Scenario Communication Rating Form (ISCRF) [ 11 , 20 , 21 ], respectively ( Multimedia Appendices 9 and ).…”

Section: Methodsmentioning

confidence: 99%

Simulation-Based Training of Non-Technical Skills in Colonoscopy: Protocol for a Randomized Controlled Trial

Khan¹,

Scaffidi²,

Walsh³

et al. 2017

JMIR Res Protoc

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BackgroundNon-technical skills (NTS), such as communication and professionalism, contribute to the safe and effective completion of procedures. NTS training has previously been shown to improve surgical performance. Moreover, increases in NTS have been associated with improved clinical endoscopic performance. Despite this evidence, NTS training has not been tested as an intervention in endoscopy.ObjectiveThe aim of this study is to evaluate the effectiveness of a simulation-based training (SBT) curriculum of NTS on novice endoscopists’ performance of clinical colonoscopy.MethodsNovice endoscopists were randomized to 2 groups. The control group received 4 hours of interactive didactic sessions on colonoscopy theory and 6 hours of SBT. Hours 5 and 6 of the SBT were integrated scenarios, wherein participants interacted with a standardized patient and nurse, while performing a colonoscopy on the virtual reality (VR) simulator. The NTS (intervention) group received the same teaching sessions but the last hour was focused on NTS teaching. The NTS group also reviewed a checklist of tasks relevant to NTS concepts prior to each integrated scenario case and was provided with dedicated feedback on their NTS performance during the integrated scenario practice. All participants were assessed at baseline, immediately after training, and 4 to 6 weeks post-training. The primary outcome measure is colonoscopy-specific performance in the clinical setting.ResultsIn total, 42 novice endoscopists completed the study. Data collection and analysis is ongoing. We anticipate completion of all assessments by August 2017. Data analysis, manuscript writing, and subsequent submission for publication is expected to be completed by December 2017.ConclusionsResults from this study may inform the implementation of NTS training into postgraduate gastrointestinal curricula. NTS curricula may improve attitudes towards patient safety and self-reflection among trainees. Moreover, enhanced NTS may lead to superior clinical performance and outcomes in colonoscopy.Trial RegistrationClinicaltrial.gov NCT02877420; https://www.clinicaltrials.gov/ct2/show/NCT02877420 (Archived by WebCite at http://www.webcitation.org/6rw94ubXX NCT02877420)

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“…[6667] Education and assessment of nontechnical skills in surgery leads to enhanced surgeons’ performance in the OR that will improve quality as well as patient safety. [1268] Surgical educators are gradually involving virtual and E-learning tools in surgical training and the distance learning arm of these modalities makes E-learning more attractive and feasible.…”

Section: Objective Measurement Of Technical and Nontechnical Surgicalmentioning

confidence: 99%

The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review

Forgione

Guraya²

2017

J Res Med Sci

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Background:Historically, operating room (OR) has always been considered as a stand-alone trusted platform for surgical education and training. However, concerns about financial constraints, quality control, and patient safety have urged the surgical educators to develop more cost-effective, surgical educational platforms that can be employed outside the OR. Furthermore, trained surgeons need to regularly update their surgical skills to keep abreast with the emerging surgical technologies. This research aimed to explore the value of currently available modern surgical tools that can be used outside the OR and also elaborates the existing laparoscopic surgical training programs in world-class centers across the globe with a view to formulate a blended and unified structured surgical training program.Materials and Methods:Several data sources were searched using MeSH terms “Laparoscopic surgery” and “Surgical training” and “Surgical curriculum” and “fundamentals of endoscopic surgery” and “fundamentals of laparoscopic surgery” and “Telementoring” and “Box trainer.” The eligibility criteria used in data extraction searched for original and review articles and by excluding the editorial articles, short communications, conference proceedings, personal view, and commentaries. Data synthesis and data analysis were done by reviewing the initially retrieved 211 articles. Irrelevant and duplicate and redundant articles were excluded from the study.Results:Finally, 12 articles were selected for this systematic review. Data results showed that a myriad of cutting-edge technical innovations have provided modern surgical training tools such as the simulation-based mechanical and virtual reality simulators, animal and cadaveric labs, telementoring, telerobotic-assisted surgery, and video games. Surgical simulators allow the trainees to acquire surgical skills in a tension-free environment without supervision or time constraints.Conclusion:The existing world-renowned surgical training centers employ various clusters of training tools that essentially endeavor to embed the acquisition of knowledge and technical skills. However, a unified training curriculum that may be accepted worldwide is currently not available.

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Surgeons' and trainees' perceived self-efficacy in operating theatre non-technical skills

Cited by 19 publications

References 23 publications

Medical school predictors of later perceived mastery of clinical work among Norwegian doctors: a cohort study with 10-year and 20-year follow-up

Medical school predictors of later perceived mastery of clinical work among Norwegian doctors: a cohort study with 10-year and 20-year follow-up

Simulation-Based Training of Non-Technical Skills in Colonoscopy: Protocol for a Randomized Controlled Trial

The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review

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