Aptitude and attitude: predictors of performance during and after basic laparoscopic skills training

Does gender influence learning, perceptions and retention in regional anatomy dissection courses?

Medical educators should understand the differences within the medical student population, including gender. Research on gender effects on learning and skill acquisition has yielded contradictory results, particularly in anatomy learning among undergraduate medical students. While various dissection course settings have been evaluated, gender-specific differences have largely been overlooked. This study examined gender differences in several aspects of anatomy education. First, the ability of undergraduate medical students to identify anatomical structures was assessed to determine gender differences in learning gains. Second, learning outcomes were compared between a 3-month and a 1-month regional anatomy course, with attention to gender. Third, knowledge retention was evaluated at 6- and 12-month follow-ups. Finally, student perceptions of different embalming methods for anatomy learning were assessed with a focus on gender. Minor differences were observed between genders across different regions in learning gains. Scores from the 3-month course were higher than those from the 1-month course, regardless of gender, particularly for the neck, thorax, and abdomen. A significant knowledge gain was noted in abdominal anatomy at the 6- and 12-month follow-up: scores improved by 56% in females and by 68% in males. The comparison of Thiel- versus ethanol-based embalming revealed gender differences regarding tissue pliability and the utility of tissues for achieving learning objectives. In conclusion, subtle differences appear to exist between female and male students in terms of perceptions and learning outcomes in gross anatomy dissection courses. These findings will be useful in developing new curricula for undergraduate medical students, taking into account gender differences in the context of regional anatomy dissection courses.

EEG connectivity and BDNF correlates of fast motor learning in laparoscopic surgery

This paper investigates the neural mechanisms underlying the early phase of motor learning in laparoscopic surgery training, using electroencephalography (EEG), brain-derived neurotrophic factor (BDNF) concentrations and subjective cognitive load recorded from n = 31 novice participants during laparoscopy training. Functional connectivity was quantified using inter-site phase clustering (ISPC) and subjective cognitive load was assessed using NASA-TLX scores. The study identified frequency-dependent connectivity patterns correlated with motor learning and BDNF expression. Gains in performance were associated with beta connectivity, particularly within prefrontal cortex and between visual and frontal areas, during task execution (r = - 0.73), and were predicted by delta connectivity during the initial rest episode (r = 0.83). The study also found correlations between connectivity and BDNF, with distinct topographic patterns emphasizing left temporal and visuo-frontal links. By highlighting the shifts in functional connectivity during early motor learning associated with learning, and linking them to brain plasticity mediated by BDNF, the multimodal findings could inform the development of more effective training methods and tailored interventions involving practice and feedback.

Investigation of factors that influence the relationship between mental rotation ability and anatomy learning

BACKGROUND

Mental rotation is a cognitive process that involves the rotation of a mental representation of an object. This ability is important for medical students in studying anatomy as this subject requires the understanding of positional relations between organs.

OBJECTIVES

To find the effect of video learning of anatomy, training, gender, and type of practical exam on mental rotation ability. Also, to find correlation between mental rotation and anatomy scores.

METHODS

Two groups were recruited: group A studied practical anatomy online using videos due to the COVID-19 pandemic lockdown; group B studied anatomy labs on-campus on plastic models. Both groups underwent a mental rotation test. Group A took labs on-campus during their second year and this was considered a training course for their mental rotation ability. Both groups, then, took a second mental rotation test. Group A was finally given a practical anatomy exam using plastic models.

RESULTS

Males scored higher than females, though not significantly. The intervention course produced no significant change in mental rotation score of group A. Mental rotation score was correlated more with the theoretical anatomy exams than the MCQ-based practical exam, for both groups. For group A, mental rotation was better correlated with the model-based than the MCQ-based practical exam, especially the post-training score.

CONCLUSION

For students to take full advantage of their mental rotation ability, not only their practical anatomy sessions but their practical anatomy exams should be on anatomical specimens and not just videos or images.

Development of laparoscopic skills in skills-naïve trainees using self-directed learning with take-home laparoscopic trainer boxes

Background

To determine if take home laparoscopic trainer boxes with only self-directed learning can develop laparoscopic skills in surgically naive learners.

Methods

74 starting PGY1 OB/Gyn residents and OB/Gyn clerkship medical students volunteered for the study. Learners performed a laparoscopic peg transfer task with only task instructions and no additional training. Initial tasks were recorded and scored. The participants took home a laparoscopic trainer box for 3 weeks to practice without guidance and returned to perform the same task for a second/final score. Initial and final scores were compared for improvement. This improvement was compared to practice and variables such as demographics, surgical interest, comfort with laparoscopy, and past experiences.

Results

Mean peg transfer task scores improved from 287 (SD = 136) seconds to 193 (SD = 79) seconds (p < 0.001). Score improvement showed a positive correlation with number of home practice sessions with a linear regression R2 of 0.134 (p = 0.001). More practice resulted in larger increases in comfort levels, and higher comfort levels correlated with better final task scores with a linear regression R2 of 0.152 (p < 0.001). Interest in a surgical specialty had no impact on final scores or improvement. Playing a musical instrument and having two or more dexterity-based hobbies was associated with a better baseline score (p = 0.032 and p = 0.033 respectively), but no difference in the final scores or score improvement. No other past experiences impacted scores.

Conclusions

Our study demonstrates that the use of home laparoscopic box trainers can develop laparoscopic skills in surgical novices even without formal guidance or curriculum.