Self-Guided Video Review of Performance Does Not Improve Learning in Basic Simulated Tasks

Daniel Box, BS, Nilay Shah, MD, Benoit Mapa, BS, Rollin Nagel, PhD, David Way, MS, Rebecca Dettorre, CCRC, Alan E Harzman, MD. The Ohio State University Medical Center, Columbus, Ohio

Introduction Video recording of laparoscopic procedures has become simple and inexpensive in many institutions. Our goal was to determine if assigning trainees to review videos of their performance of laparoscopic tasks without further coaching would speed their learning of the tasks.

Methods Twenty five medical students (years 2-4) and 25 junior residents (PGY1 and PGY2) performed the bean drop, block move, and running string laparoscopic simulated tasks. They repeated each task 10 times, with a week break between repetitions 5 and 6. Subjects were randomized to watch (experimental group, n = 25) or not watch (control group, n = 25) the recording of their performances after each attempt. The sample size was chosen with power to detect a 10% difference between the groups. The tasks were performed in the ProMIS® (Haptica Ltd., Dublin, Ireland) box, which recorded time, smoothness and path length. Two-way ANOVA with repeated measures on one factor (10 task repetitions) was used to analyze performance differences between the two groups.

Results Table 1 shows that there was statistically significant improvement across time in the entire cohort. However, there was no significant difference between the intervention and control groups. That is, they both improved but at similar rates.

Conclusions As expected, repeated practice improves performance on these basic tasks. However, unguided review of a novice’s own performance does not lead to significantly improved performance on simple tasks. Whether unguided review helps with longer tasks and what degree of guided review might help will be the subject of further investigation.