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document
A role for error training in surgical technical skill instruction and evaluation . BACKGROUND During the evaluation of many instances of the same basic surgical skill , we observed that there were several errors that occurred frequently . Two studies were undertaken to examine the use of these errors for improving the instruction and evaluation of the skill . MATERIALS AND METHODS For both studies , two types of rater training videotapes were developed . One involved the use of examples of common errors ( error ) and the other demonstrated the skill being performed correctly ( correct ) . A testing videotape was created consisting of 24 performances of the skill that ranged in quality of the performance . The first study was designed to assess the impact of error instruction on skill acquisition . In this study , a group of 30 senior medical students were randomly assigned to one of four different training groups : none , error only , correct only , and error+correct . Subjects were videotaped performing the skill before and after the training and three experts evaluated these performances independently using a 7-point rating scale . The second study was designed to assess the impact of error training on skill evaluation and was done using both novice and expert raters . The same group of 30 senior medical students used in the first study was used as novice raters . Following training in one of the four training groups , each subject rated the 24 performances on the testing videotape and interrater reliability was assessed for each group . Surgical faculty served as expert raters in this study and were randomly assigned to receive either error training or no training . Each subject viewed the testing videotape , rating the performances and giving " feedback " commentary . Interrater reliability was calculated for the two groups and the precision of the feedback was assessed . RESULTS Significant improvement in posttest performance scores was seen only in the " error+correct " training group . Interrater reliability was somewhat lower for the " correct only " and " error only " training groups in both the student and faculty studies . Faculty raters receiving error training had a higher proportion of specific comments than the group that received no training although this difference was not statistically significant . CONCLUSIONS Instruction about common errors , when combined with instruction about the correct performance enhanced the acquisition of this surgical skill . This suggests a role for the use of errors in surgical technical skill instruction . Our study provides no support for a role for error training in improving skill evaluation .
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Intervention_Educational
error training
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Intervention_Surgical
surgical technical skill instruction and evaluation .
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Intervention_Educational
two types of rater training videotapes
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Intervention_Educational
examples of common errors ( error )
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Intervention_Educational
skill being performed correctly ( correct )
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Intervention_Educational
error instruction
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Intervention_Educational
none , error only , correct only , and error+correct .
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Intervention_Educational
error training
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Intervention_Educational
testing videotape and interrater reliability
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Intervention_Educational
error training
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Intervention_Control
no training .
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Intervention_Educational
" error+correct "
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Intervention_Surgical
surgical technical skill instruction .
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Outcome_Other
skill acquisition
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Outcome_Mental
.
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Outcome_Other
performances
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Outcome_Physical
Interrater reliability
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Outcome_Physical
posttest performance scores
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Outcome_Other
Interrater reliability