Simulation-based skills training: a qualitative interview study exploring surgical trainees' experience of stress.

Area of Science:

• Medical Education
• Surgical Training
• Simulation Technology

Background:

• Stress impacts technical skill acquisition in surgery.
• Simulation-based training (SBT) offers a controlled environment for surgical skill development.
• Trainee stress during laparoscopic SBT is not well understood.

Purpose of the Study:

• To explore surgical trainees' subjective stress experiences during mandatory laparoscopic SBT.
• To identify factors within simulation training that elicit stress in trainees.

Main Methods:

• Qualitative study utilizing semistructured individual interviews.
• Twenty surgical trainees participated in interviews during advanced laparoscopic surgery courses.
• Inductive qualitative content analysis was used to analyze interview data.

Main Results:

• Three themes emerged: simulation task requirements, psychomotor skill levels, and internal pressures.
• Specific stressors included task difficulty, time constraints, poor haptic feedback, unrealistic graphics, inconsistent performance, and self-imposed pressures.
• Stress experiences varied based on trainees' laparoscopic experience and psychomotor skills.

Conclusions:

• Stress during laparoscopic SBT has both simulation-related and psychological components.
• Technical and efficiency demands of simulation tasks stress less experienced trainees.
• Self-imposed pressures can influence performance, suggesting stress may enhance simulation outcomes.
• Optimizing SBT requires attention to realism, clear objectives, individual differences, and psychological safety.