Al Fayyadh Mohammed J, Hassan Ramy A, Tran Zachary K, Kempenich Jason W, Bunegin Leonid, Dent Daniel L, Willis Ross E
Department of Surgery, University of Texas Health Science Center at San Antonio, School of Medicine, San Antonio, Texas.
Department of Surgery, University of Texas Health Science Center at San Antonio, School of Medicine, San Antonio, Texas.
J Surg Educ. 2017 Nov-Dec;74(6):e55-e61. doi: 10.1016/j.jsurg.2017.08.005. Epub 2017 Aug 31.
We examined the effect of timing and type of feedback on medical students' knot-tying performance using visual versus auditory and immediate versus delayed feedback. We hypothesized that participants who received immediate auditory feedback would outperform those who received delayed and visual feedback.
Sixty-nine first- and second-year medical students were taught to tie 2-handed knots. All participants completed 3 pretest knot-tying trials without feedback. Participants were instructed to tie a knot sufficiently tight to stop the "blood" flow while minimizing the amount of force applied to the vessel. Task completion time was not a criterion. Participants were stratified and randomly assigned to 5 experimental groups based on type (auditory versus visual) and timing (immediate versus delayed) of feedback. The control group did not receive feedback. All groups trained to proficiency. Participants completed 3 posttest trials without feedback.
There were fewer trials with leak (p < 0.01) and less force applied (p < 0.01) on the posttest compared to the pretest, regardless of study group. The immediate auditory feedback group required fewer trials to achieve proficiency than each of the other groups (p < 0.01) and had fewer leaks than the control, delayed auditory, and delayed visual groups (p < 0.02).
In a surgical force feedback simulation model, immediate auditory feedback resulted in fewer training trials to reach proficiency and fewer leaks compared to visual and delayed forms of feedback.
我们研究了反馈的时间和类型对医学生打结操作表现的影响，比较了视觉反馈与听觉反馈以及即时反馈与延迟反馈的效果。我们假设，接受即时听觉反馈的参与者的表现会优于接受延迟反馈和视觉反馈的参与者。
指导69名大一和大二医学生学习双手打结。所有参与者在无反馈的情况下完成3次打结预测试验。要求参与者系一个足够紧的结以阻止“血液”流动，同时尽量减少对血管施加的力量。任务完成时间不作为评判标准。根据反馈的类型（听觉与视觉）和时间（即时与延迟），将参与者分层并随机分配到5个实验组。对照组不接受反馈。所有组均训练至熟练水平。参与者在无反馈的情况下完成3次打结后测试验。
与预测试相比，无论研究组如何，后测试中出现渗漏的试验次数更少（p < 0.01），施加的力量也更小（p < 0.01）。即时听觉反馈组达到熟练水平所需的试验次数比其他各组都少（p < 0.01），且渗漏次数比对照组、延迟听觉反馈组和延迟视觉反馈组都少（p < 0.02）。
在手术力反馈模拟模型中，与视觉反馈和延迟反馈形式相比，即时听觉反馈能减少达到熟练水平所需的训练试验次数，且渗漏次数更少。
