Subtask training is superior to total task training for medical students learning prostate surgery
Research Activities, November 2009
Training prostate surgery as distinct subtasks is more beneficial to medical students than teaching it as an entire procedure, according to a new study from researchers at the University of Minnesota. The team used a previously studied virtual reality surgery simulator to teach 18 first- and second-year medical students at the University of Minnesota how to perform a surgery called transurethral resection of the prostate (TURP), which involves removing all or part of the prostate gland through a scope. Students were given 45 minutes to learn how to perform a TURP on the simulator, either by practicing four distinct subtasks or just repeating the full task from start to finish. The group that learned with subtask training outperformed the full task training group on two measures: the total amount of tissue that was resected and performance with the "cutting pedal" responsible for removing tissue during the procedure. The students who learned to perform a TURP in stages gave this approach an average grade of 4 on a 5-point scale, while the team that learned the procedure in one fell swoop rated their experience a 3.1.
The authors suggest that this lower rating may be a result of the students' frustration at having to try to put numerous psychomotor skills together simultaneously. The capacity of this virtual reality surgery simulator to break down complicated procedures and to measure progress enhances its usefulness as a training tool, the authors state. Having this tool is especially important because urology residents are unable to perform as many TURPS as they once did, because enlarged prostates can now also be treated though medication or other surgeries. This study was funded in part by the Agency for Healthcare Research and Quality (HS15597). See “Task deconstruction facilitates acquisition of transurethral resection of prostate skills on a virtual reality trainer,” by Thekke Adiyat Kishore, M.D., Richard Beddingfield, Timothy Holden, and others in the April 2009 Journal of Endourology 23(4), pp. 665-668.