title: Research Residents' perceptions of skill decay: Effects of repeated skills assessments and scenario difficulty.
abstract: BACKGROUND
  Skills decay is a known risk for surgical residents who have dedicated research time. We hypothesize that simulation-based assessments will reveal significant differences in perceived skill decay when assessing a variety of clinical scenarios in a longitudinal fashion.
  
  
  METHODS
  Residents (N = 46; Returning: n = 16, New: n = 30) completed four simulated procedures: urinary catheterization, central line, bowel anastomosis, and laparoscopic ventral hernia repair. Perception surveys were administered pre- and post-simulation.
  
  
  RESULTS
  Perceptions of skill decay and task difficulty were similar for both groups across three procedures pre- and post-simulation. Due to a simulation modification, new residents were more confident in urinary catheterization than returning residents (F(1,4) = 11.44, p = 0.002). In addition, when assessing expectations for skill reduction, returning residents perceived greater skill reduction upon reassessment when compared to first time residents (t(35) = 2.37, p = 0.023).
  
  
  CONCLUSIONS
  Research residents may benefit from longitudinal skills assessments and a wider variety of simulation scenarios during their research years. TABLE OF CONTENTS SUMMARY: As part of a longitudinal study, we assessed research residents' confidence, perceptions of task difficulty and surgical skill reduction. Residents completed surveys pre- and post-experience with four simulated procedures: urinary catheterization, subclavian central line insertion, bowel anastomosis, and laparoscopic ventral hernia repair. Returning residents perceived greater skill reduction upon reassessment when compared to residents participating for the first time. In addition, modification of the clinical scenarios affected perceptions of skills decay.
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Grace F
authors.initials: GF
authors.lastname: Jones
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA; University of Wisconsin-Madison, School of Engineering, Department of Industrial and Systems Engineering, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Forsyth
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Caitlin G
authors.initials: CG
authors.lastname: Jenewein
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Rebecca D
authors.initials: RD
authors.lastname: Ray
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: DiMarco
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA; University of Wisconsin-Madison, School of Engineering, Department of Industrial and Systems Engineering, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA. Electronic address: pugh@surgery.wisc.edu.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Pugh
mesh_terms: D000714:Anastomosis, Surgical; D002405:Catheterization, Central Venous; D002983:Clinical Competence; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education; D006555:Hernia, Ventral / Q000601:surgery; D006801:Humans; D007396:Internship and Residency; D007422:Intestines / Q000601:surgery; D010535:Laparoscopy; D008137:Longitudinal Studies; D008297:Male; D015146:Midwestern United States; D012054:Reinforcement, Psychology; D020377:Self Efficacy; D000066908:Simulation Training; D014546:Urinary Catheterization
keywords: Confidence; Education; Resident; Self-efficacy; Simulation; Skill decay