Optimizing the Timing of Expert Feedback During Simulation-Based Spaced Practice of Endourologic Skills.
BACKGROUND
Provision of expert feedback is widely acknowledged to be an essential component of simulation-based training. However, little is known about the most effective and efficient ways to provide feedback to novices. Optimizing the timing of expert feedback may improve outcomes while reducing resource requirements. The main objective of this study was to determine the impact of providing early versus late expert feedback to novice learners engaged in a flexible ureteroscopy (fURS) training curriculum.


METHODS
Senior medical students were recruited to participate in this study. Each student participated in a comprehensive fURS training curriculum that included 3 deliberate, independent practice sessions. Baseline and postcourse fURS skill was assessed for each student using a standardized fURS test task. Each student was randomized to either an early feedback group (EFG) or late feedback group (LFG). The EFG participants were provided expert feedback immediately after the baseline skill test, whereas LFG participants were given feedback before their final deliberate, independent practice session.


RESULTS
Eighteen senior medical students completed the study (9 EFG and 9 LFG participants). There were no discernible demographic differences between the groups at baseline. When controlling for pretest performance, early rather than late feedback was associated with both shorter postcourse time to completion of the task (19.2 vs. 21.5 minutes, P < 0.01) and higher performance scores (13.1 vs. 10.5, P < 0.01).


CONCLUSIONS
This study offers preliminary evidence that novice learners may benefit more from early feedback when learning a novel skill. Further study is required.
From the Division of Urology, St Michael's Hospital, University of Toronto (J.Y.L.), Toronto, ON; and Urologic Sciences (E.M.M.), University of British Columbia, Vancouver, BC, Canada; and University of Illinois in Chicago (M.L., A.T.), Chicago, IL.
Jason Young
JY
Lee
Elspeth M
EM
McDougall
Matthew
M
Lineberry
Ara
A
Tekian
D002983:Clinical Competence; D004724:Endoscopy / Q000193:education*; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D008297:Male; D058996:Quality Improvement; D000066908:Simulation Training; D013337:Students, Medical; D013997:Time Factors; D014570:Urologic Diseases / Q000175:diagnosis*