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The effect of repeated full immersion simulation training in ureterorenoscopy on mental workload of novice operators

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Title: The effect of repeated full immersion simulation training in ureterorenoscopy on mental workload of novice operators
Authors: Abe, Takashige Browse this author →KAKEN DB
Dar, Faizan Browse this author
Amnattrakul, Passakorn Browse this author
Aydin, Abdullatif Browse this author
Raison, Nicholas Browse this author
Shinohara, Nobuo Browse this author →KAKEN DB
Khan, Muhammad Shamim Browse this author
Ahmed, Kamran Browse this author
Dasgupta, Prokar Browse this author
Keywords: Ureterorenoscopy
Simulation training
Mental workload
Issue Date: 22-Aug-2019
Publisher: BioMed Central
Journal Title: BMC medical education
Volume: 19
Issue: 1
Start Page: 318
Publisher DOI: 10.1186/s12909-019-1752-2
PMID: 31438934
Abstract: Background Difficult surgical procedures may result in a higher mental workload, leading to increased fatigue and subsequent errors. This study was aimed to investigate the effect of repeated simulation training in ureterorenoscopy in a high-fidelity setting on the performance and mental workload of novice operators. Methods Medical students voluntarily participated in the present simulation study. After a didactic and video-based lecture, they underwent simulation training involving a renal stone case, including a rigid cystoscope component (task 1, performing a WHO checklist, assembling a scope, and insertion of a guide-wire and an access sheath after examining the bladder) and a flexible ureterorenoscope component (task 2, retrieving a stone located in the upper calyx using a basket after inspecting the upper, middle, and lower calyx). Training was performed in a mock operating theater. Technical skills were assessed by one author (an experienced urologist) onsite using an Objective Structured Assessment of Technical Skills (OSATS) score at each training session. The mental workload was subjectively evaluated by the National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire after each training session. Results Seventeen students completed a minimum of 6 training sessions (male: female = 10: 7, median age of 22) over a median of 21 days (range, 10-32). In both tasks 1 and 2, the OSATS score improved over the 6 sessions with evidence of plateauing (MANOVA model, task 1: p < 0.0001, task 2: p < 0.0001). In contrast, the NASA-TLX score persistently decreased without plateauing (task 1: p = 0.0005, task 2: p = 0.0028). Conclusions Under repeated simulation training in ureterorenoscopy in a high-fidelity setting, participants showed a continual decrease of the mental workload, while the improvement of technical skills reached a plateau over the 6 sessions. Our study showed the important benefit of simulation training to reduce the mental workload by repeated scenario training before actual clinical practice.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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