Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Surgery. 2011 Jan;149(1):1-6. doi: 10.1016/j.surg.2010.03.006. Epub 2010 Apr 28.
In the initial phases of surgical training, attentional resources are monopolized by the execution of novel tasks. This consideration can result in overwhelming attentional resources, leaving few for other tasks. Practicing a technical task decreases the attentional resources required for its execution. These resources are then free for redistribution to other, clinically important tasks. This pilot study investigated how laboratory-based surgical training on a technical procedure affects concurrent acquisition of other, nontechnical information.
After watching an instructional video, 16 first-year surgical residents performed a pyloroplasty procedure and were divided randomly so half received 6 trials of hands-on practice of the procedure (practice group) whereas the other did not (no practice). After 1 week, participants returned to perform the procedure on 2 tests: isolated procedural performance (transfer) and concurrent procedural and listening performance (dual). Procedural and listening performances were compared between groups using expert measures of performance (Global Rating Scale [GRS], task-specific checklist, and number of errors) and written test scores.
GRS and error scores reflected greater practice group performance on both tests: transfer test (P < .05 for all measures) and dual test (GRS, P < .05; error, P < .001). Most important, the practice group also retained more clinical information, indicated by higher written test scores (P < .001).
Findings in this study suggest that practice outside of the operating room may result in a decrease in attentional resources dedicated to technical task execution, thus facilitating trainees' ability to distribute attentional resources between concurrent, clinically important task performances.
在外科培训的初始阶段,注意力资源被执行新任务所垄断。这可能导致注意力资源过度集中,几乎没有剩余资源用于其他任务。练习一项技术任务会减少执行该任务所需的注意力资源。然后,这些资源可以重新分配给其他临床重要任务。这项初步研究调查了在实验室进行技术程序的外科训练如何影响同时获取其他非技术信息。
16 名一年级外科住院医师观看教学视频后,随机分为两组,其中一半接受 6 次动手练习该程序(练习组),而另一半则不练习(无练习组)。一周后,参与者返回进行两项测试:程序的单独执行(转移)和程序和听力执行的同时进行(双重)。使用专家绩效评估(整体评分量表 [GRS]、特定任务检查表和错误数量)和书面测试成绩比较两组的程序和听力表现。
GRS 和错误评分反映了两组在两项测试中的表现:转移测试(所有测量值的 P <.05)和双重测试(GRS,P <.05;错误,P <.001)。最重要的是,练习组在书面测试中也保留了更多的临床信息,得分更高(P <.001)。
本研究的结果表明,在手术室之外进行的练习可能会导致用于执行技术任务的注意力资源减少,从而提高受训者在同时进行的临床重要任务之间分配注意力资源的能力。