Improving surgical performance of free gingival graft harvesting through training and instruction

The present study assessed the influence of training and instruction on fine motor skills in periodontal plastic surgery.

Undergraduate dental students (n = 41) at the University of Leuven were randomly assigned to four different training groups, each with varying training intervals and total durations. These students were further categorized into two learning approaches: implicit (n = 21) and explicit (n = 20). Initially, the unexperienced participants were tasked with harvesting a free gingival graft on an apple with specified dimensions. They were evaluated on following parameters: surgical outcome, efficiency, and execution. After a 3-week training period, participants repeated the technical test from baseline, with a surprise test featuring altered graft dimensions.

All proposed aspects of surgical performance improved during training, including graft volumetric precision (p = 0.14), completion time (p = 0.05), and Objective Structured Assessment of Technical Skills scoring (p < 0.001). "Daily trainers" outperformed "weekly trainers," followed by "one-time trainers," with "zero trainers" showing the least improvement. Regarding instruction, the implicit learning approach solely demonstrated significantly reduced task completion time during the surprise test (p < 0.001).

These findings highlighted the benefit of frequent training on surgical performance for novice trainees learning the execution of a specific periodontal procedure, while increased instruction intensity did not yield additional advantages.