Wisse Robert Pl, Coster Tessa, Van der Schaaf Marieke, Ten Cate Olle
Department of Ophthalmology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands.
Department of Education, Universiteit Utrecht, Utrecht, The Netherlands.
BMJ Simul Technol Enhanc Learn. 2017 Jul 6;3(3):111-115. doi: 10.1136/bmjstel-2016-000137. eCollection 2017.
To describe ophthalmology residents' motivation and self-efficacy during cataract surgery training and to assess the relationship of self-efficacy and motivation on both simulator (Eyesi) and real-life surgical performance.
Prospective cohort study using a within-subject design. Eight residents were asked to fill out questionnaires on self-efficacy and motivation towards the Eyesi simulator and real-life cataract surgery at three different moments. Simulator performance was derived from the instrument's output. Patient charts were reviewed to assess real-life surgical performance.
Comparative analysis, using a paired sampled t-test, showed a significant increase in self-efficacy towards real-life cataract surgery after completing the cataract training on the simulator (p=0.005). Furthermore, we found a significant correlation between total tasks to complete the cataract training and self-efficacy scored after working with the simulator (p=0.038). Motivation towards the simulator remained stable over time and seemed not to be influenced by simulator or real-life performance.
We found evidence that performance on the simulator correlated with residents' self-efficacy scored after the simulator training, supporting the theory that self-efficacy is determined by prior performance. Self-efficacy seemed inversely related to the ease of completion of a task: delivery of a greater effort leads to more satisfaction and a higher perceived self-efficacy towards this particular task. Future studies should include more subjects to provide a more accurate insight in the role of self-efficacy and motivation in training complex surgical skills.
描述眼科住院医师在白内障手术培训期间的动机和自我效能感，并评估自我效能感和动机与模拟器（Eyesi）及现实手术表现之间的关系。
采用受试者内设计的前瞻性队列研究。八名住院医师被要求在三个不同时间点填写关于对Eyesi模拟器及现实白内障手术的自我效能感和动机的问卷。模拟器表现源自仪器输出。查阅患者病历以评估现实手术表现。
使用配对样本t检验的比较分析显示，在模拟器上完成白内障培训后，对现实白内障手术的自我效能感显著提高（p = 0.005）。此外，我们发现完成白内障培训的总任务数与使用模拟器后的自我效能感得分之间存在显著相关性（p = 0.038）。随着时间推移，对模拟器的动机保持稳定，似乎不受模拟器或现实表现的影响。
我们发现证据表明模拟器上的表现与模拟器培训后住院医师的自我效能感得分相关，支持自我效能感由先前表现决定的理论。自我效能感似乎与完成任务的难易程度呈负相关：付出更多努力会带来更多满足感以及对该特定任务更高的自我效能感认知。未来研究应纳入更多受试者，以便更准确地洞察自我效能感和动机在复杂手术技能培训中的作用。
