Teaching first or teaching last: does the timing matter in simulation-based surgical scenarios?

Area of Science:

• Medical Education
• Surgical Training
• Simulation-Based Learning

Background:

• The optimal timing for instruction within simulation-based learning remains an area of active investigation.
• Understanding how instructional timing impacts knowledge acquisition is crucial for effective surgical training.

Purpose of the Study:

• To compare the effects of teaching surgical trainees before versus after simulation scenarios on knowledge outcomes.
• To investigate the influence of instructional timing on learning in simulation-based medical education.

Main Methods:

• A pretest/posttest crossover study design was employed with medical students and surgical residents (PGY 1-3).
• Participants completed three instructional modules (endocrine surgery, trauma resuscitation, team training), each with a teaching-first and teaching-last sequence.
• Knowledge was assessed using identical multiple-choice tests before and after each session, with data analyzed using repeated-measures ANOVA.

Main Results:

• Mean pretest knowledge scores were comparable between groups.
• A statistically significant difference in the change in scores from pretest to posttest was observed between the teaching-first and teaching-last groups (p = 0.002).
• Participants in the teaching-last group achieved higher mean posttest scores (8.24) compared to the teaching-first group (6.68).

Conclusions:

• Instruction delivered after simulation scenarios leads to superior knowledge gains in surgical trainees.
• Potential mechanisms include reduced cognitive overload, stress mitigation, or enhanced activation of prior knowledge when learning occurs post-simulation.