Browsing by Author "Mizota, Tomoko"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment
    (Elsevier, 2019-02) Anton, Nicholas E.; Mizota, Tomoko; Timsina, Lava R.; Whiteside, Jake A.; Myers, Erinn M.; Stefanidis, Dimitrios; Surgery, School of Medicine
    Introduction Several studies demonstrated that simulator-acquired skill transfer to the operating room is incomplete. Our objective was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room. Methods Trainees completed baseline assessments including intracorporeal suturing (IS) performance, attentional selectivity, self-reported use of mental skills, and self-reported prior clinical and simulated laparoscopic experience and confidence. Residents then followed proficiency-based laparoscopic skills training, and their skill transfer was assessed on a live-anesthetized porcine model. Predictive characteristics for transfer test performance were assessed using multiple linear regression. Results Thirty-eight residents completed the study. Automaticity, attentional selectivity, resident perceived ability with laparoscopy and simulators, and post-training IS performance were predictive of IS performance during the transfer test. Conclusions Promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. Mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal.
  • Thumbnail Image
    Item
    Mental Skills Training Limits the Decay in Operative Technical Skill under Stressful Conditions: Results of a Multisite, Randomized Controlled Study
    (Elsevier, 2019-06) Anton, Nicholas E.; Mizota, Tomoko; Whiteside, Jake A.; Myers, Erinn M.; Bean, Eric A.; Stefanidis, Dimitrios; Surgery, School of Medicine
    Background Overwhelming stress in the operating room can lead to decay in operative performance, particularly for residents who lack experience. Mental skills training can minimize deterioration in performance during challenging situations. We hypothesized that residents trained on mental skills would outperform controls under increased stress conditions in the simulated operating room. Methods Residents from Indiana University enrolled voluntarily in this institutional review board–approved study. Residents were stratified according to baseline characteristics and randomized into a mental skills and control group. Both groups trained to proficiency in laparoscopic suturing, but only the mental skills group received mental skills training. After training, technical skill transfer was assessed under regular and stressful conditions on a porcine model. Performance was assessed using an objective suturing score. The Test of Performance Strategies was used to assess the use of mental skills. Data were combined and compared with data that had been collected at Carolinas Healthcare System because residents underwent the same protocol. Results A total of 38 residents completed all study elements. There were no differences in the effects observed between sites. We observed no group differences at baseline. The groups achieved similar technical performance at baseline, posttest, and transfer test under low-stress conditions, but the mental skills group outperformed the control group during the transfer test under high-stress conditions. Conclusion Our comprehensive mental skills curriculum implemented with surgery residents at two institutions was effective at minimizing the deterioration of resident technical performance under stressful conditions compared with controls. These results provide further evidence for the effectiveness of mental skills training to optimize surgery trainees’ technical performance during challenging clinical situations.
  • Thumbnail Image
    Item
    Surgeons see anatomical structures faster and more accurately compared to novices: Development of a pattern recognition skill assessment platform
    (Elsevier, 2018) Mizota, Tomoko; Anton, Nicholas E.; Stefanidis, Dimitrios; Surgery, School of Medicine
    Background This study aimed to identify differences in pattern recognition skill among individuals with varying surgical experience. Methods Participants reviewed laparoscopic cholecystectomy videos of various difficulty, and paused them when the cystic duct or artery was identified to outline each structure on the monitor. Time taken to identify each structure, accuracy and work load, which was assessed using the NASA-Task Load Index (TLX), were compared among the three groups. Results Ten students, ten residents and eight attendings participated in the study. Attendings identified the cystic duct and artery significantly faster and more accurately than students, and identified the cystic artery faster than residents. The NASA-TLX score of attendings was significantly lower than that of students and residents. Conclusions Attendings identified anatomical structures faster, more accurately, and with less effort than students or residents. This platform may be valuable for the assessment and teaching of pattern recognition skill to novice surgeons. Short summary Accurate anatomical recognition is paramount to proceeding safely in surgery. The assessment platform used in this study differentiated recognition skill among individuals with varing surgical experience.
  • Thumbnail Image
    Item
    Use of non-technical skills can predict medical student performance in acute care simulated scenarios
    (Elsevier, 2018) Cha, Jackie S.; Anton, Nicholas E.; Mizota, Tomoko; Hennings, Julie M.; Rendina, Megan A.; Stanton-Maxey, Katie; Ritter, Hadley E.; Stefanidis, Dimitrios; Yu, Denny; Surgery, School of Medicine
    Background Though the importance of physician non-technical (NT) skills for safe patient care is recognized, NT skills of medical students, our future physicians, has received little attention. This study aims to investigate the relationship of medical student NT skills and clinical performance during acute care team simulation (ACTS). Methods Forty-one medical students participated in ACTS. A nurse confederate facilitated and evaluated clinical performance. Two raters assessed participants’ NT skills using an adapted NT assessment tool and overall NT skills score was calculated. Regressions predicting clinical performance using NT constructs were conducted. Results Overall NT skills score significantly predicted students’ clinical performance (r2 = 0.178, p = 0.006). Four of the five individual NT constructs also significantly predicted performance: communication (r2 = 0.120, p = 0.027), situation awareness (r2 = 0.323, p < 0.001), leadership (r2 = 0.133, p = 0.019), and decision making (r2 = 0.163, p = 0.009). Conclusions Medical student NT skills can predict clinical performance during ACTS. NT skills assessments can be used for targeted education for better feedback to students.