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Is Teaching Simple Surgical Skills Using an Operant Learning Program More Effective Than Teaching by Demonstration?
I Martin Levy1, Karen W Pryor2, Theresa R McKeon3
1Department of Orthopaedic Surgery, Montefiore Medical Center, 1250 Waters Place, 11th Floor, Bronx, NY, 10461, USA. mlevy@montefiore.org.
Clinical Orthopaedics and Related Research
|September 16, 2015
Summary
Operant learning, using acoustic feedback, significantly improved surgical skill precision in knot tying and drilling tasks compared to demonstration alone. While initial learning was slower, ultimate performance accuracy was enhanced.
Area of Science:
- Surgical education research
- Behavioral science in medicine
- Operant conditioning principles
Background:
- Surgical procedures are complex behaviors built from foundational components.
- Operant learning principles, utilizing reinforcement, can enhance behavior acquisition.
- The application of operant learning for surgical skill acquisition remains underexplored.
Purpose of the Study:
- To compare the efficacy of operant learning with acoustic reinforcement versus traditional demonstration for surgical skill acquisition.
- To determine if operant learning leads to more precise surgical task performance.
Main Methods:
- Two surgical tasks (knot tying, low-angle drilling) were taught to medical students using operant learning with acoustic feedback.
- Control groups learned the same tasks through demonstration alone.
- Surgical precision and speed were objectively measured by an experienced surgeon.
Main Results:
- The operant learning group demonstrated significantly higher precision in tying a locking, sliding knot (100% vs. 33% success).
- Operant learning group showed superior consistency in performing the ideal six-step technique for low-angle drilling.
- Initial time to perform tasks was longer with operant learning, but time for repetitive tasks (10 knots) and 10 drill holes showed no significant difference.
Conclusions:
- Operant learning, when applied during the construction of surgical behaviors and reinforced, leads to accurate skill acquisition.
- The primary benefit of operant learning in surgical training lies in enhanced precision and accurate behavior outcomes, not necessarily time efficiency.
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