The Next Surgical Skills and Technology Elective Program: The “Surgical Skills and Technology Elective Program” Decreases Cognitive Load During Suturing Tasks in Second Year Medical Students

• Published in: The Journal of surgical research Vol. 267; pp. 598 - 604
• Main Authors: McInnis, Carter, Asif, Hamza, Ajzenberg, Henry, Wang, Peter, Mosa, Adam, Dang, Frances, Savage, Tyson, Vo, Thin Xuan, Wang, Justin, Zevin, Boris, Mann, Stephen, Winthrop, Andrea
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2021
• Subjects: Cognitive load; Medical education; Procedural skills; SSTEP; Surgical bootcamp; Surgical education; Medical education; Cognitive load; Procedural skills; Surgical bootcamp; SSTEP; Surgical education
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2021.06.006

•Cognitive load (CL) assessment is useful in simulation and medical education.•SSTEP participants reported reduced levels of mental effort (CL) while suturing.•Participants had increased working memory available for secondary learning.•Technical skills bootcamps may prepare students for complex learning environments.•Educators should consider learner CL during clinical and procedural teaching.
The Surgical Skills and Technology Elective Program (SSTEP) is a one-week, simulation-based procedural skills bootcamp for preclinical medical students. Using cognitive load (CL) as a useful framework for understanding simulation in medical education, our aims were to (1) examine the ability of SSTEP to decrease medical students’ CL during procedural skills training and (2) determine the impact of SSTEP on secondary learning.
In this prospective cohort study, twenty SSTEP participants and twenty controls were recruited. CL was assessed during a simple suturing task and a clinical vignette multitasking activity, where participants were required to suture and concurrently listen to a clinical vignette. CL was measured using the validated Subjective Rating of Mental Effort (SRME) and its impact on working memory was assessed using a knowledge test about the clinical vignette.
Participants reported lower SRME scores while suturing following SSTEP, which persisted at 3 months (p = 0.002) and were significantly lower than controls (p = 0.031). Participants also reported lower SRME scores during the clinical vignette multitasking activity (p = 0.011), despite no improvement among controls (p = 0.63). Participants significantly outperformed controls on the clinical vignette knowledge test (p = 0.02).
Surgical skills training through SSTEP was associated with lower reports of mental effort and increased performance on secondary learning tasks. Procedural skills bootcamps may better prepare students for the complex learning environments encountered during clinical clerkship.