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Cognitive task analysis for teaching technical skills in an inanimate surgical skills laboratory.

Abstract：

BACKGROUND:The teaching of surgical skills is based mostly on the traditional "see one, do one, teach one" resident-to-resident method. Surgical skills laboratories provide a new environment for teaching skills but their effectiveness has not been adequately tested. Cognitive task analysis is an innovative method to teach skills, used successfully in nonmedical fields. The objective of this study is to evaluate the effectiveness of a 3-hour surgical skills laboratory course on central venous catheterization (CVC), taught by the principles of cognitive task analysis to surgical interns. METHODS:Upon arrival to the Department of Surgery, 26 new interns were randomized to either receive a surgical skills laboratory course on CVC ("course" group, n = 12) or not ("traditional" group, n = 14). The course consisted mostly of hands-on training on inanimate CVC models. All interns took a 15-item multiple-choice question test on CVC at the beginning of the study. Within two and a half months all interns performed CVC on critically ill patients. The outcome measures were cognitive knowledge and technical-skill competence on CVC. These outcomes were assessed by a 14-item checklist evaluating the interns while performing CVC on a patient and by the 15-item multiple-choice-question test, which was repeated at that time. RESULTS:There were no differences between the two groups in the background characteristics of the interns or the patients having CVC. The scores at the initial multiple-choice test were similar (course: 7.33 +/- 1.07, traditional: 8 +/- 2.15, P = 0.944). However, the course interns scored significantly higher in the repeat test compared with the traditional interns (11 +/- 1.86 versus 8.64 +/- 1.82, P = 0.03). Also, the course interns achieved a higher score on the 14-item checklist (12.6 +/- 1.1 versus 7.5 +/- 2.2, P <0.001). They required fewer attempts to find the vein (3.3 +/- 2.2 versus 6.4 +/- 4.2, P = 0.046) and showed a trend toward less time to complete the procedure (15.4 +/- 9.5 versus 20.6 +/- 9.1 minutes, P = 0.149). CONCLUSIONS:A surgical skills laboratory course on CVC, taught by the principles of cognitive task analysis and using inanimate models, improves the knowledge and technical skills of new surgical interns on this task.

journal_name

Am J Surg

journal_title

American journal of surgery

authors

Velmahos GC,Toutouzas KG,Sillin LF,Chan L,Clark RE,Theodorou D,Maupin F

doi

10.1016/j.amjsurg.2002.12.005

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

114-9

issue

eissn

0002-9610

issn

1879-1883

pii

S0002961003004501

journal_volume

187

pub_type

临床试验,杂志文章,随机对照试验

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Cognitive task analysis for teaching technical skills in an inanimate surgical skills laboratory.