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A role for error training in surgical technical skill instruction and evaluation.

David A Rogers1, Glenn Regehr, Jeannie MacDonald

  • 1Department of Surgery, Southern Illinois University School of Medicine, P.O. Box 19655, Springfield, IL 62794-9655, USA. drogers@siumed.edu

American Journal of Surgery
|April 12, 2002
PubMed
Summary

Instruction on common surgical errors combined with correct technique training significantly improved skill acquisition. Error training alone did not enhance skill evaluation or interrater reliability.

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Area of Science:

  • Medical Education
  • Surgical Skills Training
  • Performance Evaluation

Background:

  • Frequent errors in basic surgical skills were observed during performance evaluations.
  • Two studies were conducted to investigate the utility of these errors in improving surgical skill instruction and evaluation.

Purpose of the Study:

  • To assess the impact of error-based instruction on surgical skill acquisition.
  • To evaluate the effect of error training on the reliability of skill assessment by novice and expert raters.

Main Methods:

  • Two training videotapes were developed: one with common errors and one demonstrating correct performance.
  • Participants were trained in different groups (none, error only, correct only, error+correct) and videotaped performing the skill.
  • Novice and expert raters evaluated performances, with interrater reliability assessed across training groups.

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Main Results:

  • The "error+correct" training group showed significant improvement in posttest skill performance.
  • Interrater reliability was lower in groups trained with "correct only" or "error only" instruction.
  • Faculty raters receiving error training provided more specific feedback, though not statistically significant.

Conclusions:

  • Combining instruction on common errors with correct performance techniques enhances surgical skill acquisition.
  • Error-based instruction shows promise for improving surgical technical skills training.
  • Error training did not demonstrate a role in improving skill evaluation or interrater reliability.