Abstract
Purpose To determine whether "chronometric pressure" (i.e., a verbal prompt to increase speed) could predictably alter medical learners' speed-accuracy trade-off during a simulated surgical task, thus modifying the challenge. Method The authors performed a single-task, interrupted time-series study, enrolling surgery residents and medical students from two institutions in September and October 2015. Participants completed 10 repetitions of a simulated blood vessel ligation (placement of two ligatures 1 cm apart). Between repetitions 5 and 6, participants were verbally encouraged to complete the next repetition 20% faster than the previous one. Outcomes included time and accuracy (ligature tightness, placement distance). Data were analyzed using random-coefficients spline models. Results The authors analyzed data from 78 participants (25 medical students, 16 first-year residents, 37 senior [second-year or higher] residents). Overall, time decreased from the 1st (mean [standard deviation] 39.8 seconds [18.4]) to the 10th (29.6 [12.5]) repetition. The spline model showed a decrease in time between repetitions 5 and 6 of 8.6 seconds (95% confidence interval: -11.1, -6.1). The faster time corresponded with declines in ligature tightness (unadjusted difference -19%; decrease in odds 0.86 [0.76, 0.98]) and placement accuracy (unadjusted difference -5%; decrease in odds 0.86 [0.75, 0.99]). Significant differences in the speed-accuracy trade-off were seen by training level, with senior residents demonstrating the greatest decline in accuracy as speed increased. Conclusions Chronometric pressure influenced the speed-accuracy trade-off and modified the challenge level in a simulated surgical task. It may help unmask correctable deficiencies or false plateaus in learners' skill development.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 920-928 |
| Number of pages | 9 |
| Journal | Academic Medicine |
| Volume | 93 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2018 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Education
Cite this
Is Speed a Desirable Difficulty for Learning Procedures? An Initial Exploration of the Effects of Chronometric Pressure. / Gas, Becca L.; Buckarma, Eeeln H.; Cook, David Allan; Farley, David R.; Pusic, Martin V.
In: Academic Medicine, Vol. 93, No. 6, 01.06.2018, p. 920-928.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Is Speed a Desirable Difficulty for Learning Procedures? An Initial Exploration of the Effects of Chronometric Pressure
AU - Gas, Becca L.
AU - Buckarma, Eeeln H.
AU - Cook, David Allan
AU - Farley, David R.
AU - Pusic, Martin V.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Purpose To determine whether "chronometric pressure" (i.e., a verbal prompt to increase speed) could predictably alter medical learners' speed-accuracy trade-off during a simulated surgical task, thus modifying the challenge. Method The authors performed a single-task, interrupted time-series study, enrolling surgery residents and medical students from two institutions in September and October 2015. Participants completed 10 repetitions of a simulated blood vessel ligation (placement of two ligatures 1 cm apart). Between repetitions 5 and 6, participants were verbally encouraged to complete the next repetition 20% faster than the previous one. Outcomes included time and accuracy (ligature tightness, placement distance). Data were analyzed using random-coefficients spline models. Results The authors analyzed data from 78 participants (25 medical students, 16 first-year residents, 37 senior [second-year or higher] residents). Overall, time decreased from the 1st (mean [standard deviation] 39.8 seconds [18.4]) to the 10th (29.6 [12.5]) repetition. The spline model showed a decrease in time between repetitions 5 and 6 of 8.6 seconds (95% confidence interval: -11.1, -6.1). The faster time corresponded with declines in ligature tightness (unadjusted difference -19%; decrease in odds 0.86 [0.76, 0.98]) and placement accuracy (unadjusted difference -5%; decrease in odds 0.86 [0.75, 0.99]). Significant differences in the speed-accuracy trade-off were seen by training level, with senior residents demonstrating the greatest decline in accuracy as speed increased. Conclusions Chronometric pressure influenced the speed-accuracy trade-off and modified the challenge level in a simulated surgical task. It may help unmask correctable deficiencies or false plateaus in learners' skill development.
AB - Purpose To determine whether "chronometric pressure" (i.e., a verbal prompt to increase speed) could predictably alter medical learners' speed-accuracy trade-off during a simulated surgical task, thus modifying the challenge. Method The authors performed a single-task, interrupted time-series study, enrolling surgery residents and medical students from two institutions in September and October 2015. Participants completed 10 repetitions of a simulated blood vessel ligation (placement of two ligatures 1 cm apart). Between repetitions 5 and 6, participants were verbally encouraged to complete the next repetition 20% faster than the previous one. Outcomes included time and accuracy (ligature tightness, placement distance). Data were analyzed using random-coefficients spline models. Results The authors analyzed data from 78 participants (25 medical students, 16 first-year residents, 37 senior [second-year or higher] residents). Overall, time decreased from the 1st (mean [standard deviation] 39.8 seconds [18.4]) to the 10th (29.6 [12.5]) repetition. The spline model showed a decrease in time between repetitions 5 and 6 of 8.6 seconds (95% confidence interval: -11.1, -6.1). The faster time corresponded with declines in ligature tightness (unadjusted difference -19%; decrease in odds 0.86 [0.76, 0.98]) and placement accuracy (unadjusted difference -5%; decrease in odds 0.86 [0.75, 0.99]). Significant differences in the speed-accuracy trade-off were seen by training level, with senior residents demonstrating the greatest decline in accuracy as speed increased. Conclusions Chronometric pressure influenced the speed-accuracy trade-off and modified the challenge level in a simulated surgical task. It may help unmask correctable deficiencies or false plateaus in learners' skill development.
UR - http://www.scopus.com/inward/record.url?scp=85053899630&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053899630&partnerID=8YFLogxK
U2 - 10.1097/ACM.0000000000002167
DO - 10.1097/ACM.0000000000002167
M3 - Article
C2 - 29419552
AN - SCOPUS:85053899630
VL - 93
SP - 920
EP - 928
JO - Academic Medicine
JF - Academic Medicine
SN - 1040-2446
IS - 6
ER -