Verification of accurate technical insight: a prerequisite for self-directed surgical training.
Adv Health Sci Educ Theory Pract
; 20(1): 181-91, 2015 Mar.
Article
em En
| MEDLINE
| ID: mdl-24903585
ABSTRACT
Simulation-based surgical skills training during preclinical education is a persistent challenge due to time constraints of trainees and instructors alike. Self-directed practice is resource-efficient and flexible; however, insight into technical proficiency among trainees is often lacking. The purpose of this study is to prospectively assess the accuracy of self-assessments among medical students learning basic surgical suturing. Over seven weekly practice sessions, preclinical medical students performed serial repetitions of a simulation-based suturing task under one-on-one observation by one of four trainers. Following each task repetition, self- and trainer-assessments (SA-TA) were performed using a 36-point weighted checklist of technical standards developed a priori by expert consensus. Upon study completion, agreement between SA and TA was measured using weighted Cohen's kappa coefficients. Twenty-nine medical students each performed a median of 25 suture task repetitions (IQR 21.5-28). Self-assessments tended to overestimate proficiency during the first tertile of practice attempts. Agreement between SA and TA improved with experience, such that the weighted kappa statistics for the two-handed and instrument ties were >0.81 after 18-21 task attempts. Inexperienced trainees frequently overestimate technical proficiency through self-assessments. However, this bias diminishes with repetitive practice. Only after trainees have attained the capacity to accurately self-assess can effective self-directed learning take place.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Autoavaliação (Psicologia)
/
Estudantes de Medicina
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Cirurgia Geral
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Técnicas de Sutura
/
Competência Clínica
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Adult
/
Female
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Humans
/
Male
Idioma:
En
Revista:
Adv Health Sci Educ Theory Pract
Assunto da revista:
EDUCACAO
/
SAUDE PUBLICA
Ano de publicação:
2015
Tipo de documento:
Article