Performance goals on simulators boost resident motivation and skills laboratory attendance.
OBJECTIVE
To assess the impact of setting simulator training goals on resident motivation and skills laboratory attendance.


METHODS
Residents followed a proficiency-based laparoscopic curriculum on the 5 Fundamentals of Laparoscopic Surgery and 9 virtual reality tasks. Training goals consisted of the average expert performance on each task + 2 SD (mandatory) and best expert performance (optional). Residents rated the impact of the training goals on their motivation on a 20-point visual analog scale. Performance and attendance data were analyzed and correlated (Spearman's). Data are reported as medians (range).


METHODS
General Surgery residency program at a regional referral Academic Medical Center.


METHODS
General surgery residents (n = 15).


RESULTS
During the first 5 months of the curriculum, weekly attendance rate was 51% (range, 8-96). After 153 (range, 21-412) repetitions, resident speed improved by 97% (range, 18-230), errors improved by 17% (range, 0-24), and motion efficiency by 59% (range, 26-114) compared with their baseline. Nine (60%) residents achieved proficiency in 7 (range, 3-14) and the best goals in 3.5 (range, 1-9) tasks; the other 6 residents had attendance rates <30%. Residents rated the impact of setting performance goals on their motivation as 15 (range, 1-18) and setting a best goal as 13 (range, 1-18). Motivation ratings correlated positively with attendance rates, number of repetitions, performance improvement, and achievement of proficiency and best goals (r = 0.59-0.75; p < 0.05) but negatively with postgraduate year (PGY) (-0.67; p = 0.02).


CONCLUSIONS
Setting training goals on simulators are associated with improved resident motivation to participate in a simulator curriculum. While more stringent goals may potentiate this effect, they have a limited impact on senior residents. Further research is needed to investigate ways to improve skills laboratory attendance.
Stefanidis
Dimitrios
D
Carolinas Simulation Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
Acker
Christina E
CE
Greene
Frederick L
FL
D000328:Adult; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003162:Competency-Based Education; D003198:Computer Simulation; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D013502:General Surgery / Q000193:education*; D006040:Goals; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000592:standards*; D008297:Male; D009042:Motivation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014584:User-Computer Interface