title: Teaching technical skills: training on a simple, inexpensive, and portable model.
abstract: The purpose of this study was to determine whether surgical residents could significantly improve their performance on a specific surgical procedure after a brief practice session with feedback. Attending plastic surgeons, using valid and reliable checklists and global rating scales, objectively assessed 37 junior surgical residents while performing two-flap Z-plasties on pig thighs (one before and one after a one-on-one, 5-minute practice session with feedback). The total cost per resident was $1.00 (Canadian currency). After the practice session, total checklist scores improved from 7.3 (range, 1 to 9) to 7.9 (range, 5 to 9), and the total global rating scores improved from 29.1 (range, 13 to 41) to 31.9 (range, 19 to 43). Paired Student's t tests revealed significant improvement in both the mean total checklist scores (p < 0.05) and mean total global rating scores (p < 0.01). Also, the global rating score for appearance and quality of the final surgical product significantly improved from 2.7 to 3.3 after the practice session (p < 0.01). There were no significant differences in performance scores between men and women, between first-year and second-year residents, with residents' previous experience with the Z-plasty procedure, or with resident's base surgical specialties. The results of this prospective study indicate that training on a simple and portable model with very brief individualized practice and feedback is an effective and inexpensive way of improving resident performance. A 5-minute practice session with a surgical trainee before performing a procedure on a living patient may significantly improve the patient's surgical performance and produce a superior result.
authors.affiliation: Centre for Research in Education, University Health Network, Division of Plastic Surgery, Department of Surgery, University of Toronto, Ontario, Canada.
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Wanzel
authors.forename: Edward D
authors.initials: ED
authors.lastname: Matsumoto
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Hamstra
authors.forename: Dimitri J
authors.initials: DJ
authors.lastname: Anastakis
mesh_terms: D000328:Adult; D000818:Animals; D002170:Canada; D002983:Clinical Competence; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D066298:In Vitro Techniques; D007396:Internship and Residency; D008297:Male; D011446:Prospective Studies; D013518:Surgery, Plastic / Q000193:education; D013524:Surgical Flaps; D013552:Swine; D013664:Teaching Materials