Error tolerance: an evaluation of residents' repeated motor coordination errors

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• 作者：Katherine E. Law ; M.S.^a ; Eran C. Gwillim ; M.D.^b ; Rebecca D. Ray ; Ph.D.^b ; Anne-Lise D. D'Angelo ; M.D.^b ; Elaine R. Cohen ; M.Ed.^b ; Rebekah M. Fiers ; B.S.^b ; Drew N. Rutherford ; M.S.^c ; Carla M. Pugh ; M.D. ; Ph.D.^a ; ^b ; ^{pugh@surgery.wisc.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Assessment ; Technical skills ; Simulation ; Human factors ; Error ; Surgery education
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：212
• 期：4
• 页码：609-614
• 全文大小：739 K

文摘

The study investigates the relationship between motor coordination errors and total errors using a human factors framework. We hypothesize motor coordination errors will correlate with total errors and provide validity evidence for error tolerance as a performance metric.

Methods

Residents' laparoscopic skills were evaluated during a simulated laparoscopic ventral hernia repair for motor coordination errors when grasping for intra–abdominal mesh or suture. Tolerance was defined as repeated, failed attempts to correct an error and the time required to recover.

Results

Residents (N = 20) committed an average of 15.45 (standard deviation [SD] = 4.61) errors and 1.70 (SD = 2.25) motor coordination errors during mesh placement. Total errors correlated with motor coordination errors (r[18] = .572, P = .008). On average, residents required 5.09 recovery attempts for 1 motor coordination error (SD = 3.15). Recovery approaches correlated to total error load (r[13] = .592, P = .02).

Conclusions

Residents' motor coordination errors and recovery approaches predict total error load. Error tolerance proved to be a valid assessment metric relating to overall performance.