title: Exploring personality dimensions that influence practice and performance of a simulated laparoscopic task in the objective structured clinical examination.
abstract: BACKGROUND
  Surgical educators have encouraged the investigation of individual differences in aptitude and personality in surgical performance. An individual personality difference that has been shown to influence laparoscopic performance under time pressure is movement specific reinvestment. Movement specific reinvestment has 2 dimensions, movement self-consciousness (MS-C) (i.e., the propensity to consciously monitor movements) and conscious motor processing (CMP) (i.e., the propensity to consciously control movements), which have been shown to differentially influence laparoscopic performance in practice but have yet to be investigated in the context of psychological stress (e.g., the objective structured clinical examination [OSCE]).
  
  
  OBJECTIVE
  This study investigated the role of individual differences in propensity for MS-C and CMP in practice of a fundamental laparoscopic skill and in laparoscopic performance during the OSCE. Furthermore, this study examined whether individual differences during practice of a fundamental laparoscopic skill were predictive of laparoscopic performance during the OSCE.
  
  
  METHODS
  Overall, 77 final-year undergraduate medical students completed the movement specific reinvestment scale, an assessment tool that quantifies the propensity for MS-C and CMP. Participants were trained to proficiency on a fundamental laparoscopic skill. The number of trials to reach proficiency was measured, and completion times were recorded during early practice, later practice, and the OSCE.
  
  
  RESULTS
  There was a trend for CMP to be negatively associated with the number of trials to reach proficiency (p = 0.064). A higher propensity for CMP was associated with fewer trials to reach proficiency (β = -0.70, p = 0.023). CMP and MS-C did not significantly predict completion times in the OSCE (p > 0.05). Completion times in early practice (β = 0.05, p = 0.016) and later practice (β = 0.47, p < 0.001) and number of trials to reach proficiency (β = 0.23, p = 0.003) significantly predicted completion times in the OSCE.
  
  
  CONCLUSIONS
  It appears that a higher propensity for CMP predicts faster rates of learning of a fundamental laparoscopic skill. Furthermore, laparoscopic performance during practice is indicative of laparoscopic performance in the challenging conditions of the OSCE. The lack of association between the 2 dimensions of movement specific reinvestment and performance during the OSCE is explained using the theory of reinvestment as a framework. Overall, consideration of personality differences and individual differences in ability during practice could help inform the development of individualized surgical training programs.
authors: Institute of Human Performance, The University of Hong Kong, Hong Kong, China. Electronic address: nehamal@connect.hku.hk.
authors: Neha
authors: N
authors: Malhotra
authors: Institute of Human Performance, The University of Hong Kong, Hong Kong, China; School of Sport, Carnegie Faculty, Leeds Beckett University, United Kingdom.
authors: Jamie M
authors: JM
authors: Poolton
authors: School of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, United Kingdom.
authors: Mark R
authors: MR
authors: Wilson
authors: Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors: Gilberto
authors: G
authors: Leung
authors: Institute of Human Performance, The University of Hong Kong, Hong Kong, China; Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors: Frank
authors: F
authors: Zhu
authors: Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors: Joe K M
authors: JK
authors: Fan
authors: Institute of Human Performance, The University of Hong Kong, Hong Kong, China; Department of Sport and Leisure Studies, University of Waikato, New Zealand.
authors: Rich S W
authors: RS
authors: Masters
mesh_terms: D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D009048:Motor Skills; D010551:Personality; D000066908:Simulation Training
keywords: Medical Knowledge; OSCE; Patient Care; Practice-Based Learning and Improvement; conscious motor processing; individual differences; laparoscopic training; movement self-consciousness; movement specific reinvestment