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Examining Residents' Strategic Mindfulness During Self-Regulated Learning of a Simulated Procedural Skill.

ABSTRACT: Simulation-based training is currently embedded in most health professions education curricula. Without evidence for how trainees think about their simulation-based learning, some training techniques may not support trainees' learning strategies.This study explored how residents think about and self-regulate learning during a lumbar puncture (LP) training session using a simulator.In 2010, 20 of 45 postgraduate year 1 internal medicine residents attended a mandatory procedural skills training boot camp. Independently, residents practiced the entire LP skill on a part-task trainer using a clinical LP tray and proper sterile technique. We interviewed participants regarding how they thought about and monitored their learning processes, and then we conducted a thematic analysis of the interview data.The analysis suggested that participants considered what they could and could not learn from the simulator; they developed their self-confidence by familiarizing themselves with the LP equipment and repeating the LP algorithmic steps. Participants articulated an idiosyncratic model of learning they used to interpret the challenges and successes they experienced. Participants reported focusing on obtaining cerebrospinal fluid and memorizing the "routine" version of the LP procedure. They did not report much thinking about their learning strategies (eg, self-questioning).During simulation-based training, residents described assigning greater weight to achieving procedural outcomes and tended to think that the simulated task provided them with routine, generalizable skills. Over this typical 1-hour session, trainees did not appear to consider their strategic mindfulness (ie, awareness and use of learning strategies).

SUBMITTER: Brydges R

PROVIDER: S-EPMC4936854 | biostudies-other | 2016 Jul

REPOSITORIES: biostudies-other

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Examining Residents' Strategic Mindfulness During Self-Regulated Learning of a Simulated Procedural Skill.

Brydges Ryan R Hatala Rose R Mylopoulos Maria M

Journal of graduate medical education 20160701 3

<h4>Background</h4>Simulation-based training is currently embedded in most health professions education curricula. Without evidence for how trainees think about their simulation-based learning, some training techniques may not support trainees' learning strategies.<h4>Objective</h4>This study explored how residents think about and self-regulate learning during a lumbar puncture (LP) training session using a simulator.<h4>Methods</h4>In 2010, 20 of 45 postgraduate year 1 internal medicine residen ...[more]

PMID: 27413439

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Project description:Background and objectiveClinical observations indicate that implicit procedural learning, a central component of physical and psychosocial rehabilitation, is impeded following spinal cord injury. In accordance, previous research has revealed a specific deficit in implicit sequence learning among individuals with paraplegia using a standard, manual version of the serial reaction time task. To extend these findings and shed light on the underlying sources of potential spinal cord injury-related deficits in sequence learning, we used an ocular activated serial reaction time task to compare sequence learning performance between individuals with tetraplegia and healthy controls.Participants and measuresTwelve participants with spinal cord injury in C5-T1 were compared to 12 matched control participants on measures derived from an ocular activated serial reaction time task. Depression and additional cognitive measures were assessed to explore the source and specificity of potential sequence learning deficits.ResultsLike controls, and in contrast with previous findings in paraplegia, the spinal cord injury group showed intact implicit sequence learning, evidenced by declining reaction times and improved anticipation over the first six blocks of the serial reaction time task, and an advantage for the initial learning sequence over a novel interference sequence.ConclusionsThe ocular activated serial reaction time task elicited a performance pattern similar to standard motor versions, such that participants with tetraplegia demonstrated unimpaired sequence learning. This suggests that previously reported implicit sequence learning deficits in spinal cord injury directly involved motor functioning rather than cognitive aspects of the task, and that the ocular activated sequence learning task could be a valid alternative for assessing implicit sequence learning in populations that cannot perform spinal-cord dependent motor tasks. Implications for post-spinal cord injury rehabilitation and adjustment are discussed.

Project description:BackgroundPrevious research has strongly supported the utility of spaced learning in enhancing memory, but its effectiveness in complex surgical procedures has largely been unexplored. The main objective of this study was to evaluate whether, in comparison to concentrated learning, spaced learning improves the short-term acquisition and long-term retention of cosmetic suturing skills as outcomes of surgical resident training courses.MethodsThis randomized controlled trial was conducted from February 2023 to June 2023. Surgical residents were recruited from a teaching hospital in Guangzhou, China. The participants were randomly assigned at a 1:1 ratio to either the spaced training group (40 min of training followed by a 20-minute break) or the concentrated training group (3 h of continuous training), in which they received one-on-one training for cosmetic suturing skills. The short-term acquisition and long-term retention outcomes were evaluated by three independent raters using an objective scoring scale to assess the participants' cosmetic suturing skills before the training (pretraining test), within one hour after the training (posttraining test), and three months after the completion of the training (follow-up test). The score for each participant was calculated as the average of three independent scores.ResultsThe study included 23 surgical residents, 12 in the spaced training group and 11 in the concentrated training group. The pretraining test revealed no significant difference between the groups. However, in the post-training test, the spaced training group achieved a significantly higher total score than did the concentrated training group (74.06 ± 5.87 vs. 63.43 ± 10.73, p = 0.0070). Specifically, the suture technique scores were 28.46 ± 1.78 and 22.85 ± 3.75, respectively, which were significantly different (p = 0.0002). During the long-term follow-up test, the spaced training group consistently outperformed the concentrated training group by having significantly higher total (75.60 ± 4.78 vs. 60.68 ± 10.40, p = 0.0001), suture quality (32.26 ± 4.01 vs. 26.23 ± 4.16, p = 0.0019), suture technique (28.68 ± 2.63 vs. 22.18 ± 3.94, p = 0.0001), and suturing time scores (14.67 ± 1.15 vs. 12.27 ± 6.07, p = 0.0460).ConclusionsIncorporating the principles of spaced learning into the instructional process of obtaining cosmetic suture skills for surgical residents not only significantly enhances short-term skill improvement but also contributes to the long-term retention of training outcomes.

Project description:IntroductionSelf-regulated learning entails psychological processes that elite athletes employ to optimize their practice. Although self-regulated learning provides insights into athlete-led practice, research has been limited to few cultures, and the particularities of how SRL surveys perform in new cultural contexts require attention. Moreover, there exists no measure to assess SRL and its relationship to quality sport practice in Polish. Thus, we examined the Short Form of the Self-Regulated Learning-Sport Practice survey in Polish. Analyses addressed the factorial validity and reliability, the criterion validity (by assessing differences in scores between competition levels), and the concurrent validity (by correlating scores with conceptually related constructs) of a Polish Short Form survey.MethodsAthletes (N = 324, M age = 21.4, n females = 144, n males = 180) from amateur, regional, national, and international-elite levels completed the survey, along with concurrent subscales (General Self-Efficacy Scale; GSES; Metacognitive-Self Scale; MS-24; Action Control Scale; ACS-90).ResultsConfirmatory factor analysis indicated a two-factor (metacognitive; motivational) model (RMSEA = 0.082, SRMR = 0.057, CFI = 0.89). Between-group tests showed international-elite scoring higher than all other groups on metacognitive and motivational subscales. On both subscales, significant trends indicated that more skilled levels consistently reported higher scores than lesser-skilled levels. The short form scores were associated with certain concurrent variables, including GSES (rmeta = 0.41, rmotiv = 0.48), MS-24 (rmeta = 0.39, rmotiv = 0 .24), and ACS-90 (AOF subscale: rmotiv = 0 .26).DiscussionOn the basis of strong criterion validity, and moderate evidence for concurrent validity, we conclude that the Polish Short Form of the Self-Regulated Learning-Sport Practice survey is a promising tool for use in Polish sport and we discuss future avenues of work to enhance its validation. Limitations that inform future research include our reliance on a mixed-sport sample, the lack of priming of obstacles/challenge ahead of self-report, and a lack of consideration of sport-specific practice variables in analyses.

Project description:BackgroundPediatric emergency medicine (PEM) physicians receive training in critical procedures, but these procedures are rare in practice. The literature on maintenance of procedural skills focuses on ways to practice (e.g., via simulation) and pays little attention to motivation's role. Understanding what motivates PEM physicians to maintain procedural skills can inform the design of supportive policies and interventions. Our study explores how PEM physicians conceptualize maintenance of procedural skills, what motivates them to maintain procedural skills, and barriers to procedural skill maintenance.MethodsThis was a qualitative study of 12 PEM faculty guided by the self-determination theory (SDT) of motivation. SDT describes a typology that distinguishes extrinsic and intrinsic motivation, with intrinsic motivation based on autonomy, competence, and relatedness. Interviews were transcribed and coded using constant-comparative technique, and interviews continued until thematic sufficiency was achieved.ResultsParticipants had difficulty defining procedural skill maintenance by specific criteria and expressed ambivalence about external standards for competence, noting the need to account for individual and local practice factors. Three themes characterizing participants' motivation for procedural skills maintenance included: (1) desire to provide optimal patient care and fear of unsuccessful performance (competence), (2) procedural competence as part of the identity of a PEM physician who teaches and performs procedures (competence and relatedness), and (3) desire for accessibility and choice of options in maintaining procedural skills (autonomy). Participants identified lack of opportunities, time, and support as barriers to motivation and skills maintenance.ConclusionSDT concepts were integral to understanding faculty motivation, and this highlights the need for prioritizing faculty autonomy, competence, and relatedness in designing supports for procedural skill maintenance. Our findings regarding the difficulty in defining maintenance of skills emphasize the need for further discussion and study of this topic.

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Examining Residents' Strategic Mindfulness During Self-Regulated Learning of a Simulated Procedural Skill.

Publications

Examining Residents' Strategic Mindfulness During Self-Regulated Learning of a Simulated Procedural Skill.

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