The Role of Anxiety in Simulation-Based Dexterity and Overall Performance: Does It Really Matter?

ABSTRACT

Background: Essential Skills in the Management of Surgical Cases (ESMSC) is an international undergraduate surgical masterclass which combines ex vivo, dry lab and high fidelity in vivo simulation-based learning (SBL). It consists of 32 stations of skills-based learning, including open reduction internal fixation (ORIF) of fractures. Current literature suggests early involvement in skills-based learning at the undergraduate level is vital. Aims: To compare students' dexterity and skills-based performance with demographic and educational background parameters. Methods: 112 medical students from European Union countries including the United Kingdom, Germany, Greece, Cyprus, Germany, and Bulgaria were selected from a competitive pool of candidates to attend the course. Students undertook ORIF in an ex vivo swine model, and in a simulated fracture on a bamboo rod. Skills-based performance was assessed by two consultant surgeons with validated direct observation of procedural skills (DOPS) forms. Anxiety was self-assessed using the Westside Anxiety Scale prior to the ORIF stations. Dexterity was measured with the O'Connor tweezer dexterity test. Results: Female students had significantly higher dexterity scores (median difference 7, p =.003). Right-handed students achieved higher dexterity than left-handed students (median difference 7, p =.043). There was no difference in students' performance across different medical schools, and across year groups (p <.05 for any correlation). Self-reported anxiety was not correlated with high fidelity skills-based performance (r = 0.032, p =.74). Conclusion: Anxiety does not seem to play a significant role in Simulation Skills-Based learning. Undergraduate surgical curricula should incorporate SBL-based modules to enhance practical skills learning and motivate future orthopedic surgeons.

Keywords::

• dexterity
• simulation-based learning
• undergraduate surgical education

This article refers to:

Invited Commentary on “The Role of Anxiety in Simulation-Based Dexterity and Overall Performance: Does It Really Matter?”

DECLARATION OF INTEREST

Authors declare no conflict of interest.

ACKNOWLEDGMENTS

Michail Sideris and Apostolos Papalois are founders and lead the ESMSC project since 2013. Michail Sideris, Fatema Dhaif, and Georgios Paparoidamis are equal contributors as first authors. Michail Sideris, Georgios Paparoidamis, Apostolos Papalois, and Eleftherios Tsiridis have conceived the study. Apostolos Papalois, Michael Potoupnis, and Eleftherios Tsiridis are the senior authors of the study. John Hanrahan, Efstratia-Maria Georgopoulou, Ismini Tsagkaraki, and Nikolaos Staikoglou are Medical Students who collected, organized, and set up the database. Fatema Dhaif has performed the statistical analysis approved by Michail Sideris. Ferha Saeed is a senior advisor of the study. Anastasios Tzavellas and Theodoros Michail are senior orthopedic trainees who taught on the module. All the Authors have contributed to Data Collection as well as assessors (Workplace Based Assessments of the Medical Students). Special thanks to Experimental Research Centre ELPEN Faculty and especially Georgios Stagias—Felasa C and Nikolaos Psychalakis—Felasa C.

FUNDING OF THE PROJECT

Essential Skills in the Management of the Surgical Patient—ESMSC is funded by a Research Grant supported by Experimental Research Centre ELPEN S.A., and it is provided for free to Medical Students around Europe.

ETHICS

European and National Legislation, Directive 63/2010, PD 56/Αpril 2013

Reference Number of the License: Michail Ch. Sideris and Apostolos Papalois 7095/05-11-2014 (revised 884 28/4/2015)

MANUAL OF THE COURSE

Essential Skills in the Management of Surgical Cases—ESMSC Sideris, Papalois et al., Scientific Publications Parisianou S.A., ISBN: 978-960-583-063-2.