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Towards an effective MIS simulator-based training with basic laparoscopic tasks: The impact of time pressure on the learning process

Weimer, Carl Otto Heinrich (2019) Towards an effective MIS simulator-based training with basic laparoscopic tasks: The impact of time pressure on the learning process.

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Abstract:Background: Laparoscopy has become the new standard for operating within the human body. The new technique comes with very different demands for the surgeon in order to be successful during minimally invasive surgery. Learning the skills was usually done with the model of apprenticeship, however recent studies suggest that this is not the ideal process of learning motor skills for laparoscopy anymore. Simulator-based training provides an effective alternative to acquire the necessary skills in a safe environment. In order to optimize the training with the simulators, it was found that errors could improve the learning process. To evoke a higher error rate, we saw the possibility to insert a time pressure episode to the simulator-based training. Based on previous experiments (Gas et al., 2018), it was expected that time pressure would have an impact the performance. Therefore, we assumed that time pressure could evoke a change in the learning process. Methods: To test for the influence of time pressure, we employed a time-series study with 40 participants. Each participant had to run through three phases, the first one without time pressure, the second one with verbally induced time pressure and the last phase again without time pressure. Each phase was modeled in a learning curve and bundled together to populationaveraged learning curves. We were interested in the population-level maximum performance reflecting the best performance one can reach if continuing the training. A lower asymptote would reflect a better performance and an enhanced learning effect of the training. Additionally, the individual-level maximum performance gave insights into the influence on time-pressure on the performance of each individual. Furthermore, a pairwise correlation between the phases has been calculated, to assess the internal consistency of the tasks. Results: The findings suggest that the time pressure phase shows observable changes in the maximum performance of the learner. Furthermore, comparing the maximum performances of the first and the last phase revealed that the time pressure phase has a positive effect on the maximum performance in terms of time-on-task and damage in the long run. The correlation between the phases was mediocre, however with a high degree of uncertainty. Conclusion: Findings suggests that time pressure improves the performance in simulator-based training. This confirms earlier findings on induced time pressure during training and adds, that time pressure has an observable impact on the learning process. The high error rate during the time pressure phase would suggest that training with provoked errors certainly has a positive impact on skill acquisition. Further research needs to investigate how time pressure can be implemented in a training program in the most effective way
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:44 medicine, 77 psychology
Programme:Psychology BSc (56604)
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