How Do Feedback and Instructions Affect the Performance of a Simulated Surgical Task?

Purpose

This study was conducted to objectively evaluate the effect of feedback and instructional material on the acquisition of surgical psychomotor skills for a model system based on mandibular fracture repair.

Materials and Methods

This study was a prospective cohort study comprised of students in the preclinical years of dental or medical education. The students were divided into 4 groups and exposed to different levels of feedback/written instructions (including none) in the testing environment. Each subject was given a pair of aluminum bars, representing a fractured human mandible, and a standardized set of tools, including a fixed length of stainless steel wire to fix the bars together. The strength of fixation was measured, using a calibrated testing apparatus, as the amount of load that the fixed sample could tolerate to the point of failure. All subjects completed 5 successive trials under the same conditions. Descriptive statistics were recorded to provide comparisons between groups. Bivariate statistics were computed to compare the different study groups; multiple-comparison testing was used to evaluate differences among the groups. A P value ≤ .05 was considered statistically significant.

Results

The sample was comprised of 61 students, divided into 4 groups. The students who received neither instructions nor feedback had the lowest average performance scores. Those who received both feedback and instructions had the highest average performance scores. The students who received instructions only fared better than those who received feedback only, but only immediately after receiving instructions. Differences between the groups tended to dissipate after a few trials.

Conclusions

Written instructions and performance feedback can enhance the acquisition of psychomotor skills related to the performance of a complex task.