个性化视频反馈与重复任务练习可提高腹腔镜打结技能：两项对照试验。
Personalized Video Feedback and Repeated Task Practice Improve Laparoscopic Knot-Tying Skills: Two Controlled Trials.
作者信息
Abbott Eduardo F, Thompson Whitney, Pandian T K, Zendejas Benjamin, Farley David R, Cook David A
机构信息
E.F. Abbott is a simulation fellow, Mayo Clinic Multidisciplinary Simulation Center, Mayo Clinic College of Medicine, Rochester, Minnesota, and adjunct instructor of internal medicine, Department of Internal Medicine, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; ORCID: http://orcid.org/0000-0001-5713-4809. W. Thompson is a medical student, University of Minnesota Medical School, Minneapolis, Minnesota. T.K. Pandian is a resident, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota. B. Zendejas is a pediatric surgery fellow, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. D.R. Farley is professor of surgery and consultant, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota. D.A. Cook is professor of medicine and professor of medical education; research chair, Mayo Clinic Multidisciplinary Simulation Center; director of research, Office of Applied Scholarship and Education Science; and Consultant in the Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota; ORCID: http://orcid.org/0000-0003-2383-4633.
出版信息
Acad Med. 2017 Nov;92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S26-S32. doi: 10.1097/ACM.0000000000001924.
PURPOSE
Compare the effect of personalized feedback (PF) vs. task demonstration (TD), both delivered via video, on laparoscopic knot-tying skills and perceived workload; and evaluate the effect of repeated practice.
METHOD
General surgery interns and research fellows completed four repetitions of a simulated laparoscopic knot-tying task at one-month intervals. Midway between repetitions, participants received via e-mail either a TD video (demonstration by an expert) or a PF video (video of their own performance with voiceover from a blinded senior surgeon). Each participant received at least one video per format, with sequence randomly assigned. Outcomes included performance scores and NASA Task Load Index (NASA-TLX) scores. To evaluate the effectiveness of repeated practice, scores from these trainees on a separate delayed retention test were compared against historical controls who did not have scheduled repetitions.
RESULTS
Twenty-one trainees completed the randomized study. Mean change in performance scores was significantly greater for those receiving PF (difference = 23.1 of 150 [95% confidence interval (CI): 0, 46.2], P = .05). Perceived workload was also significantly reduced (difference = -3.0 of 20 [95% CI: -5.8, -0.3], P = .04). Compared with historical controls (N = 93), the 21 with scheduled repeated practice had higher scores on the laparoscopic knot-tying assessment two weeks after the final repetition (difference = 1.5 of 10 [95% CI: 0.2, 2.8], P = .02).
CONCLUSIONS
Personalized video feedback improves trainees' procedural performance and perceived workload compared with a task demonstration video. Brief monthly practice sessions support skill acquisition and retention.
目的
比较通过视频提供的个性化反馈（PF）与任务示范（TD）对腹腔镜打结技能和感知工作量的影响；并评估重复练习的效果。
方法
普通外科实习生和研究员每隔一个月完成四次模拟腹腔镜打结任务。在重复任务的中间阶段，参与者通过电子邮件收到TD视频（专家示范）或PF视频（他们自己表现的视频，并配有一位不知情的资深外科医生的画外音）。每个参与者每种形式至少收到一个视频，顺序随机分配。结果包括表现分数和美国国家航空航天局任务负荷指数（NASA-TLX）分数。为了评估重复练习的有效性，将这些学员在单独的延迟保留测试中的分数与没有安排重复练习的历史对照组进行比较。
结果
21名学员完成了随机研究。接受PF的学员表现分数的平均变化显著更大（差异=150分中的23.1分[95%置信区间（CI）：0，46.2]，P = 0.05）。感知工作量也显著降低（差异=20分中的-3.0分[95%CI：-5.8，-0.3]，P = 0.04）。与历史对照组（N = 93）相比，21名安排了重复练习的学员在最后一次重复后两周的腹腔镜打结评估中得分更高（差异=10分中的1.5分[95%CI：0.2，2.8]，P = 0.02）。
结论
与任务示范视频相比，个性化视频反馈可提高学员的操作表现和感知工作量。每月简短的练习课程有助于技能的获得和保留。
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