Practice does not always make perfect: need for selection curricula in modern surgical training

Area of Science:

• Medical Education
• Surgical Training
• Skill Acquisition

Background:

• Surgical trainees' ability to achieve technical competence varies despite practice.
• Assessing learning patterns is crucial for understanding surgical skill acquisition.
• Consistency of learning patterns across open and laparoscopic tasks needs evaluation.

Purpose of the Study:

• To assess surgical trainees' technical competence acquisition.
• To analyze learning patterns in surgical skill development.
• To determine if learning patterns are consistent across diverse surgical tasks.

Main Methods:

• Sixty-five preclinical medical students underwent training in 5 open and laparoscopic tasks.
• Standardized feedback was provided over 40 repetitions for each task.
• Data mining identified 4 learning clusters, comparing performance and learning curves.

Main Results:

• Top and high performers (up to 42% and 35%) achieved proficiency in all tasks.
• Moderate performers mastered open tasks but not all laparoscopic ones.
• Low performers (8-15%) failed most tasks, particularly laparoscopic procedures, showing no plateau.

Conclusions:

• Most trainees gain proficiency, but a significant subset struggles with laparoscopic skills.
• Low-performing trainees exhibit persistent deficits, especially in complex laparoscopic procedures.
• Screening for low performers in surgical training programs, particularly for laparoscopy, is recommended.