Barriers and facilitators to deliberate practice using take-home laparoscopic simulators

Vivienne I Blackhall (Corresponding Author), Jennifer Cleland, Philip Wilson, Susan J Moug, Kenneth G Walker

Research output: Contribution to journalArticle

Abstract

Background
Several regions in the UK and Ireland have delivered home-based laparoscopic simulation programmes in an attempt to progress surgical trainees’ skills through deliberate practice. However, engagement with these programmes has been poor. This study aims to uncover the barriers to engagement with home-based simulation, with a view to developing an improved programme.

Methods
This was a qualitative study using focus groups with key stakeholders including junior surgical trainees, consultants/attendings and simulation faculty. Data were collected across four regions in three countries. Data were audio-recorded, transcribed and a thematic analysis was performed using NVivo software.

Results
Sixty-three individuals were interviewed in 12 focus groups (43 trainees, 20 trainers). Trainees cited competing commitments as a barrier to engaging with home-based simulation. They tended to focus on scoring ‘points’ towards career progression rather than viewing tasks as interesting, or associated with personal development. Their view was that this approach is perpetuated by the training system, which rewards trainees for publications and exams, but not for operative skill. Trainees were unsatisfied with metric feedback and wanted individual feedback from consultants (attendings). Trainees perceived consultants as lacking interest in the programmes and training in general. However, some consultants were unaware of the programmes being delivered and others felt lacking in confidence to deliver the necessary training.

Conclusions
Scheduled simulation sessions which provide trainees with the opportunity for consultant feedback may improve engagement. Tackling the ‘point-scoring’ culture is more challenging. This could be addressed by modified assessment structures, greater recognition and accountability for trainers, and recognition and funding of simulation strategies including in-house skills sessions
Original languageEnglish
Pages (from-to)2951–2959
Number of pages9
JournalSurgical Endoscopy
Volume33
Issue number9
Early online date19 Nov 2018
DOIs
Publication statusPublished - Sep 2019

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Keywords

  • deliberate practice
  • simulation
  • surgical training
  • laparoscopy

Cite this

Barriers and facilitators to deliberate practice using take-home laparoscopic simulators. / Blackhall, Vivienne I (Corresponding Author); Cleland, Jennifer; Wilson, Philip; Moug, Susan J; Walker, Kenneth G.

In: Surgical Endoscopy, Vol. 33, No. 9, 09.2019, p. 2951–2959.

Research output: Contribution to journalArticle

Blackhall, Vivienne I ; Cleland, Jennifer ; Wilson, Philip ; Moug, Susan J ; Walker, Kenneth G. / Barriers and facilitators to deliberate practice using take-home laparoscopic simulators. In: Surgical Endoscopy. 2019 ; Vol. 33, No. 9. pp. 2951–2959.
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