Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment - 04/01/19

Doi : 10.1016/j.amjsurg.2018.11.028

Nicholas E. Anton ^a, Tomoko Mizota ^a, Lava R. Timsina ^a, Jake A. Whiteside ^a, Erinn M. Myers ^b, Dimitrios Stefanidis ^a,^⁎
^a Department of Surgery, Indiana University School of Medicine, USA
^b Carolinas Simulation Center, Carolinas Healthcare System, USA

^∗Corresponding author. Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, EH 130, Indianapolis, IN 46202, USA.Department of SurgeryIndiana University School of Medicine545 Barnhill Dr, EH 130IndianapolisIN46202USA

Abstract

Introduction

Several studies demonstrated that simulator-acquired skill transfer to the operating room is incomplete. Our objective was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room.

Methods

Trainees completed baseline assessments including intracorporeal suturing (IS) performance, attentional selectivity, self-reported use of mental skills, and self-reported prior clinical and simulated laparoscopic experience and confidence. Residents then followed proficiency-based laparoscopic skills training, and their skill transfer was assessed on a live-anesthetized porcine model. Predictive characteristics for transfer test performance were assessed using multiple linear regression.

Results

Thirty-eight residents completed the study. Automaticity, attentional selectivity, resident perceived ability with laparoscopy and simulators, and post-training IS performance were predictive of IS performance during the transfer test.

Conclusions

Promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. Mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal.

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Highlights

•	Automaticity and attentional selectivity predict the transfer of skill.
•	Perceived ability in laparoscopic surgery was predictive of skill transfer.
•	Perceived ability on laparoscopic simulators was predictive of skill transfer.
•	Focusing on these factors may facilitate more complete skill transfer for trainees.

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Keywords : Surgery, Simulation, Stress, Mental skills, Self-efficacy