title: Performance goals on simulators boost resident motivation and skills laboratory attendance.
abstract: 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.
authors.affiliation: Carolinas Simulation Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stefanidis
authors.forename: Christina E
authors.initials: CE
authors.lastname: Acker
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Greene
mesh_terms: 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