title: Residents' perception of skill decay during dedicated research time.
abstract: BACKGROUND
  Surgery residents may take years away from clinical responsibilities for dedicated research time. As part of a longitudinal project, the study aim was to investigate residents' perceptions of clinical skill reduction during dedicated research time. Our hypothesis was that residents would perceive a greater potential reduction in skill during research time for procedures they were less confident in performing.
  
  
  METHODS
  Surgical residents engaged in dedicated research training at multiple training programs participated in four simulated procedures: urinary catheterization, subclavian central line, bowel anastomosis, and laparoscopic ventral hernia (LVH) repair. Using preprocedure and postprocedure surveys, participants rated procedures for confidence and difficulty. Residents also indicated the perceived level of skills reduction for the four procedures as a result of time in the laboratory.
  
  
  RESULTS
  Thirty-eight residents (55% female) completed the four clinical simulators. Participants had between 0-36 mo in a laboratory (M = 9.29 mo, standard deviation = 9.38). Preprocedure surveys noted lower confidence and higher perceived difficulty for performing the LVH repair followed by bowel anastomosis, central line insertion, and urinary catheterization (P < 0.05). Residents perceived the greatest reduction in bowel anastomosis and LVH repair skills compared with urinary catheterization and subclavian central line insertion (P < 0.001). Postprocedure surveys showed significant effects of the simulation scenarios on resident perception for urinary catheterization (P < 0.05) and LVH repair (P < 0.05).
  
  
  CONCLUSIONS
  Residents in this study expected greater skills decay for the procedures they had lower confidence performing and greater perceived difficulty. In addition, carefully adapted simulation scenarios had a significant effect on resident perception and may provide a mechanism for maintaining skills and keeping confidence grounded in experience.
authors.affiliation: Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin. Electronic address: ad'angelo@uwhealth.org.
authors.forename: Anne-Lise D
authors.initials: AL
authors.lastname: D'Angelo
authors.affiliation: Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
authors.forename: Rebecca D
authors.initials: RD
authors.lastname: Ray
authors.affiliation: Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
authors.forename: Caitlin G
authors.initials: CG
authors.lastname: Jenewein
authors.affiliation: Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
authors.forename: Grace F
authors.initials: GF
authors.lastname: Jones
authors.affiliation: Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Pugh
mesh_terms: D035843:Biomedical Research / Q000193:education*; D002641:Chicago; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D059032:Learning Curve; D008297:Male; D008910:Minnesota; D010465:Perception; D013514:Surgical Procedures, Operative / Q000193:education; D013997:Time Factors; D014922:Wisconsin
keywords: Confidence; Education; Resident; Self-efficacy; Simulation; Skill decay