The effect of repeated full immersion simulation training in ureterorenoscopy on mental workload of novice operators

Abstract

Background Difficult surgical procedures may result in a higher mental workload, leading to increased fatigue and subsequent errors. This study was aimed to investigate the effect of repeated simulation training in ureterorenoscopy in a high-fidelity setting on the performance and mental workload of novice operators. Methods Medical students voluntarily participated in the present simulation study. After a didactic and video-based lecture, they underwent simulation training involving a renal stone case, including a rigid cystoscope component (task 1, performing a WHO checklist, assembling a scope, and insertion of a guide-wire and an access sheath after examining the bladder) and a flexible ureterorenoscope component (task 2, retrieving a stone located in the upper calyx using a basket after inspecting the upper, middle, and lower calyx). Training was performed in a mock operating theater. Technical skills were assessed by one author (an experienced urologist) onsite using an Objective Structured Assessment of Technical Skills (OSATS) score at each training session. The mental workload was subjectively evaluated by the National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire after each training session. Results Seventeen students completed a minimum of 6 training sessions (male: female = 10: 7, median age of 22) over a median of 21 days (range, 10–32). In both tasks 1 and 2, the OSATS score improved over the 6 sessions with evidence of plateauing (MANOVA model, task 1: p < 0.0001, task 2: p < 0.0001). In contrast, the NASA-TLX score persistently decreased without plateauing (task 1: p = 0.0005, task 2: p = 0.0028). Conclusions Under repeated simulation training in ureterorenoscopy in a high-fidelity setting, participants showed a continual decrease of the mental workload, while the improvement of technical skills reached a plateau over the 6 sessions. Our study showed the important benefit of simulation training to reduce the mental workload by repeated scenario training before actual clinical practice. Electronic supplementary material The online version of this article (10.1186/s12909-019-1752-2) contains supplementary material, which is available to authorized users.

Development and validation of a porcine organ model for training in essential laparoscopic surgical skills

“…NASA‐TLX is a subjective assessment tool of workload based on six weighted subscales: mental demand, physical demand, temporal demand, performance, effort and frustration level, and has been widely utilized in a variety of fields, including medicine 21–23 . Our group also reported that under repeated simulation training in ureteroscopy in a mock operating theater, participants showed a continuous decrease in the mental workload, whereas improvements in the technical skills reached a plateau over the six sessions 24 . In the present study, although significant variability in NASA‐TLX scores existed within each group, the scores were higher in the novice group (Fig.…”

Assessment of blood pressure measurement skills in second-year medical students after ongoing simulation-based education and practice

“…Since we did not confirm that every student mastered BP reading, the session we provided in 2019 was not a typical training. However, several recent studies in medical education have reported the advantageous aspects of repeated SBE trainings[ 16–18 ]. Increased cardiopulmonary resuscitation (CPR) training repetition on a simulator with the concomitant improvement of quality in CPR performance was associated with a positive effect on the rescuer’s belief in cardiopulmonary resuscitation, according to a previous study[ 17 ].…”

“…Another study reported that repeated training on the Virtual Haptic Back (VHB) contributed to substantial retention of palpatory skills[ 18 ]. In addition, Abe et al demonstrated the effectiveness of repeated simulation training in ureterorenoscopy to reduce anxiety and improve confidence in medical students[ 16 ].…”

Impact of Simulation-Based Training on Radiation Therapists’ Workload, Situation Awareness, and Performance

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