The Spaced Learning Concept Significantly Improves Acquisition of Laparoscopic Suturing Skills in Students and Residents: A Randomized Control Trial

2020 ◽  
Author(s):  
Johannes Boettcher ◽  
Stefan Mietzsch ◽  
Julia Wenkus ◽  
Nariman Mokhaberi ◽  
Michaela Klinke ◽  
...  
Keyword(s):  
Medical Students ◽  
Training Programs ◽  
Analysis Of Covariance ◽  
Long Term Results ◽  
Knot Tying ◽  
Laparoscopic Suturing ◽  
Spaced Learning ◽  
Complex Motor ◽  
Learning Concept

Abstract Introduction Spaced learning consists of blocks with highly condensed content that interrupted by breaks during which distractor activities, such as physical activity, are performed. The concept has been shown to be superior in complex motor skill acquisition like laparoscopic suturing and knot tying. Preliminary studies have solely been conducted with medical students. Therefore, it remained unanswered if the spaced learning concept would also work for pediatric surgery residents. Materials and Methods The study aimed to evaluate the effectiveness of spaced learning, students, and residents were asked to perform four surgeons' square knots on a bowel model within 30 minutes prior and post 3 hours of hands-on training. To examine the long-term skills, the same subjects were asked to perform a comparable, but more complex task 12 months later without receiving training in the meantime. Total time, knot stability, suture accuracy, knot quality, and laparoscopic performance were assessed. Additionally, motivation was accessed by using the questionnaire on current motivation. Differences were calculated using mixed analysis of variance, Mann–Whitney U test, and multivariate analysis of covariance. Results A total of 20 medical students and 14 residents participated in the study. After randomization, 18 were trained using the spaced learning concept and 16 via conventional methods. Both groups had comparable baseline characteristics and improved significantly after training in all assessed measures. The spaced learning concept improved procedure performance as well as knot quality and stability in both students and residents. However, residents that trained via spaced learning showed significantly better long-term results regarding knot quality and speed in comparison to students. Although anxiety was significantly reduced in both training groups over time, residents were significantly more interested regarding knot tying than students. Conclusion This study dispels any remaining doubt that the spaced learning concept might only work for medical students. It appears that the spaced learning concept is very suitable for residents in acquiring complex motor skills. It is superior to conventional training, resulting in improved procedural performance as well as knot quality and speed. Hence, tailored training programs should not only be integrated early on in students' curricula but also in surgical training programs.

Spaced Education Improves the Retention of Laparoscopic Suturing Skills: A Randomized Controlled Study

2019 ◽  
Vol 30 (02) ◽  
pp. 193-200 ◽  
Author(s):  
Johannes Boettcher ◽  
Lea Klippgen ◽  
Stefan Mietzsch ◽  
Friederike Grube ◽  
Thomas Krebs ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Motor Skill ◽  
Knot Tying ◽  
Laparoscopic Suturing ◽  
Motor Skill Acquisition ◽  
Spaced Learning ◽  
Complex Motor ◽  
Learning Concept

Abstract Introduction Spaced learning has been shown to be superior in complex motor skill acquisition like laparoscopic suturing and knot tying. By using a pre–post follow-up design, the aim of the study was to evaluate the long-term impact of implementation of the spaced learning concept in laparoscopic training. Materials and Methods To evaluate the effectiveness of spaced learning, subjects were asked to perform four surgeon's square knots on a bowel model within 30 minutes—prior and after 3 hours of hands-on training. To examine the long-term skills, the same students were asked to perform a comparable, but more complex, task (four slip knots in a model of esophageal atresia) 12 months later as follow-up measurement. Total time, knot stability (evaluated via tensiometer), suture accuracy, knot quality (Muresan scale), and laparoscopic performance (Munz checklist) were assessed. Moreover, motivation was accessed using Questionnaire on Current Motivation. Results Twenty students were included in the study; after simple randomization, 10 were trained using the “spaced learning” concept and 10 via traditional methods. Both groups had comparable baseline characteristics and improved after training significantly, regarding all aspects assessed in this study. Subjects that trained via spaced learning were superior in terms of speed (p = 0.021), knot quality (p = 0.008), and suture strength (p = 0.003). Additionally, spaced learning significantly decreased anxiety (p = 0.029) and probability of success (p = 0.005). Conclusion The spaced learning concept is very suitable for long-term complex motor skill acquisition, like laparoscopic suturing and knot tying. It is superior to conventional training regarding speed and, most importantly, knot quality and stability, resulting in improved confidence and motivation. Thus, we strongly recommend to incorporate the spaced learning concept into training courses and surgical programs.

The spaced learning concept significantly improves training for laparoscopic suturing: a pilot randomized controlled study

2017 ◽  
Vol 32 (1) ◽  
pp. 154-159 ◽  
Author(s):  
Michael Boettcher ◽  
Johannes Boettcher ◽  
Stefan Mietzsch ◽  
Thomas Krebs ◽  
Robert Bergholz ◽  
...  
Keyword(s):  
Randomized Controlled Study ◽  
Controlled Study ◽  
Laparoscopic Suturing ◽  
Randomized Controlled ◽  
Spaced Learning ◽  
Learning Concept

Long-term results of radiation oncology seminar for medical students and residents held between 1995 and 2011: career paths of the participants

2013 ◽  
Vol 31 (11) ◽  
pp. 755-759 ◽  
Author(s):  
Yukihisa Tamaki ◽  
Tomoko Itazawa ◽  
Tomoyuki Okabe ◽  
Kazuma Toda ◽  
Eisuke Abe ◽  
...  
Keyword(s):  
Medical Students ◽  
Radiation Oncology ◽  
Career Paths ◽  
Long Term Results

Classical but Not Rap Music Significantly Improves Transferability and Long-Term Acquisition of Laparoscopic Suturing Skills: A Randomized Controlled Trial

2020 ◽  
Vol 30 (06) ◽  
pp. 541-547 ◽  
Author(s):  
Stefan Mietzsch ◽  
Robert Bergholz ◽  
Johannes Boettcher ◽  
Lea Klippgen ◽  
Julia Wenskus ◽  
...  
Keyword(s):  
Motor Skills ◽  
Classical Music ◽  
Skills Training ◽  
Laparoscopic Suturing ◽  
Complex Motor ◽  
And Performance ◽  
Complex Motor Skills ◽  
Suturing Skills

Abstract Introduction Acoustic distractions have been shown to increase the level of stress and workload in the operating room (OR). Noise significantly reduces surgical performance, but experienced surgeons are able to reduce the acoustic perception of their surroundings to maintain a high level of performance in complex surgical tasks. However, music has been shown to improve learning and performance of complex motor skills. The aim of this study was to evaluate the influence of music on transferability and long-term acquisition of laparoscopic suturing skills. Materials and Methods To evaluate the effects of music on training, subjects were asked to perform four surgeon's square knots on a bowel model within 30 minutes—prior and post 3 hours of hands-on training. To examine long-term skills, the same students were asked to perform a comparable, but more complex, task (four slip knots in a model of esophageal atresia) 6 months post initial training, as a follow-up measurement. Total time, knot stability (evaluated via tensiometer), suture accuracy, knot quality (Muresan scale), and laparoscopic performance (Munz checklist) were assessed. Results Twenty-four students were included in the study; after simple randomization, 16 were trained while exposed to music (eight to Bach and eight to Bushido) and eight with traditional methods. Seven were lost due to follow-up. Both groups had comparable baseline characteristics and significantly improved after training, in all parameters assessed in this study. Subjects that trained with classical music were superior in terms of speed (p = 0.006), knot quality (p = 0.014), and procedural performance (p = 0.034) compared with controls. Conclusion Music during acquisition of complex motor skills, like laparoscopic suturing and knot tying, is superior to traditional training. Especially music considered nondisturbing significantly improved speed, knot quality, and performance. Thus, incorporation of pleasant music into surgical skills training and the OR should be considered.

Validation of a Novel Needle Holder to Train Advanced Laparoscopy Skills to Novices in a Simulator Environment

2020 ◽  
Vol 27 (2) ◽  
pp. 211-219
Author(s):  
Ninos Oussi ◽  
Konstantinos Georgiou ◽  
Andreas Larentzakis ◽  
Dimitrios Thanasas ◽  
Markus Castegren ◽  
...  
Keyword(s):  
Medical Students ◽  
Scoring System ◽  
Evaluation Tool ◽  
Knot Tying ◽  
Laparoscopic Suturing ◽  
Needle Holder ◽  
Advanced Laparoscopy ◽  
Feasible Option ◽  
Suturing Skills ◽  
Trial Performance

Background. Our aim was to determine if a newly designed Najar needle holder (NNH) shortens the time for novices to improve advanced laparoscopy (AL) techniques (suturing/knot tying), compared with a conventional macro needle holder (MNH) in a simulator. Furthermore, we aimed to validate a new video scoring system determining AL skills. Methods. Forty-six medical students performed identical surgical tasks in a prospective, crossover study evaluating AL skills (NNH vs MNH). All subjects performed a double-throw knot, 2 single-throw knots following 3 running sutures in the Simball Box (SB) simulator. After resting, subjects switched needle holders. All tasks were videotaped and analyzed using SB software and by 2 independent reviewers using the Objective Video Evaluation Scoring Table (OVEST). Trial performance expressed as SB Overall Score (SBOS) and OVEST. Results. In the group starting with NNH (followed by MNH) OVEST was consistently high during both trials (median = 12.5, range = 6.5-18.0, and median = 13.5, range = 6.5-21.0; P = .2360). However, in the group starting with MNH, OVEST improved significantly when the participants changed to NNH (median = 10.0, range = 2.5-19.5, vs median = 14.5, range = 4.5-18.0; P = .0003); an improvement was also found with SBOS (median = 37%, range = 27% to 92%, vs median = 48%, range = 34% to 70%; P = .0289). In both trials, both independent reviewers’ OVEST measures correlated well: Trial 1: β = 0.97, P < .0001; and Trial 2: β = 0.95, P < .0001. A correlation also existed between SBOS and OVEST in both trials (β = 2.1, P < .0001; and β = 1.9, P = .0002). Conclusions. This study indicates a significantly higher improvement in laparoscopic suturing skills in novices training AL skills using NNH compared with MNH. Starting early, AL training in novices using NNH is a feasible option. Furthermore, OVEST used in experimental settings as an evaluation tool is comparable with the validated SBOS.

Work Analysis and Work Changes through Onsite Ergonomics Training for Small Groups

2000 ◽  
Vol 44 (12) ◽  
pp. 2-716-2-719
Author(s):  
Ana Isabel B. B. Paraguay
Keyword(s):  
Small Groups ◽  
Training Programs ◽  
Group Formation ◽  
Long Term Results ◽  
Key Factors ◽  
Short Term ◽  
Work Related ◽  
Full Discussion

This paper deals with two case studies of onsite training on Ergonomics for small groups of non-OSH professionals from two state-owned companies from São Paulo State, Brazil. Both (1997 and 1998) training programs aimed at enabling small group of employees to function as an intern Ergonomics Committee. Their main and first task was to identify, evaluate, control and prevent risk factors and WRMD - Work Related Musculoskeletal Disorders, with or without the support of external consultant/ergonomists. This paper identifies and discusses main difficulties arising from such training programs and implementing work transformations. Some of the main difficulties may arise from the scheduling of short-term courses (36 to 48h of classes) for non-OSH professionals that are not used to group work, learning on matter as WRMD. Difficulties also originate from the nature of the task: (try) to enable mostly non-ergonomists/non OSH professionals to develop group-guided actions on matter that sometimes require immediate action, specialized knowledge and long-term experience in the field of Ergonomics and diagnosis of a company's demand. Last but not the least, the paper also points out key factors to work transformations: the placing of training programs within a company's OSH policy and context; group formation criteria for such training programs; course schedule, content, planning and evaluation; the need for full discussion of the short-term and the long-term results of the training program as well as of the follow-up of any work transformations.

Telementoring of Open and Laparoscopic Knot Tying and Suturing Is Possible: A Randomized Controlled Study

2022 ◽  
Author(s):  
Julia Elrod ◽  
Johannes Boettcher ◽  
Deirdre Vincent ◽  
David Schwarz ◽  
Tina Trautmann ◽  
...  
Keyword(s):  
Medical Students ◽  
Cognitive Load ◽  
Controlled Trial ◽  
Controlled Study ◽  
Knot Tying ◽  
Laparoscopic Suturing ◽  
Continuous Training ◽  
Educational Approach ◽  
Intracorporeal Suturing ◽  
Randomized Controlled

Abstract Aim Several motor learning models have been used to teach highly complex procedural skills in medical education. The aim of this randomized controlled trial was to assess the efficiency of telementoring of open and laparoscopic suturing of medical students compared to conventional in-person teaching and training. Methods After randomization, 23 medical students were assigned to either the telementoring or the in-person training group. Both groups were taught by surgically trained residence with a student–teacher ratio of 1:1 (teacher–student). Open suturing was assessed in a model of congenital diaphragmatic hernia and laparoscopic suturing in a model of bowel anastomosis. All subjects were trained according to the spaced learning concept for 3 hours. Primary end points were time, knot quality, precision, knot strength, and overall knotting performance/competency. Furthermore, we utilized the Surgery Task Load Index to evaluate the cognitive load of both teaching techniques. Students' subjective progress regarding skill acquisitions and acceptance of telementoring was assessed using a nine-item questionnaire. Results All 23 trainees significantly improved after training in all knot attributes. More than 90% of all subjects reached proficiency in both groups. In-person training and telementoring were similarly practical, and no significant differences regarding speed, knot quality, precision, knot stability, and procedure performance/competency were found. Students perceived no difference in acquisition of factual or applicational knowledge between the two groups. General acceptance of telementoring was moderate in both groups before training, but increased during training in students actually assigned to this group, in comparison to students assigned to conventional teaching. Conclusion The current study shows that telementoring of open and laparoscopic suturing is an ideal answer to the current coronavirus disease 2019 pandemic, ensuring continuous training. On-site training and telementoring are similarly effective, leading to substantial improvement in proficiency in intracorporeal suturing and knot tying. Likewise, students' subjective progress regarding skill acquisitions and cognitive load does not differ between teaching methods. Skepticism toward telementoring decreases after exposure to this learning method. Given our results, telementoring should be considered a highly effective and resource-saving educational approach even after the current pandemic.

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