Rogers-Vizena CR, Saldanha FYL, Sideridis GD, Allan CK, Livingston KA, Nussbaum L, Weinstock PH. High-Fidelity Cleft Simulation Maintains Improvements in Performance and Confidence: A Prospective Study.
JOURNAL OF SURGICAL EDUCATION 2023;
80:1859-1867. [PMID:
37679288 DOI:
10.1016/j.jsurg.2023.08.010]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE
High-fidelity simulation has a growing role in plastic surgical education. This study tests the hypothesis that cleft lip repair simulation followed by structured debriefing improves performance and self-confidence and that gains are maintained.
DESIGN
Prospective, single-blinded interventional study with repeated measures. Trainees performed cleft lip repair on a high-fidelity simulator followed by debriefing, immediately completed a second repair, and returned 3 months later for a third session. Anonymized simulation videos were rated using the modified Objective Structured Assessment of Technical Skills (OSATS) and the Unilateral Cleft Lip Repair competency assessment tool (UCLR). Self-assessed cleft lip knowledge/confidence and procedural self-confidence were surveyed after each simulation.
SETTING
Boston Children's Hospital, a tertiary care academic hospital in Boston, MA, USA.
PARTICIPANTS
All trainees rotating through the study setting were eligible. Twenty-six participated; 21 returned for follow-up.
RESULTS
Significant improvements (p < 0.05) occurred between the first and second simulations for OSATS, UCLR, and procedural self-confidence. Significant improvement occurred between the second and third simulations cleft lip knowledge/confidence. Compared to the first simulation, improvements were maintained at the third simulation for all variables. Training level moderately correlated with score for UCLR for the first simulation (r = 0.55, p < 0.01), deteriorated somewhat with the second (r = 0.35, p = 0.08), and no longer corelated by the third (r = 0.02, p = 0.92).
CONCLUSIONS
Objective performance and subjective self-assessed knowledge and confidence improve with high-fidelity simulation plus structured debriefing and improvement is maintained. Differences in procedure-specific performance seen with increasing training level are reduced with simulation, suggesting it may accelerate knowledge and skill acquisition.
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