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Bridging the Gap: Theoretical Principles Behind Surgical Boot Camps

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Boot Camp Approach to Surgical Training

Abstract

The transition from medical school to residency is often considered the most difficult year for both teachers and learners. Previous work suggests incorporating a boot camp at the onset of residency can be a highly effective mechanism for easing the transition between medical school and residency by improving trainees’ medical knowledge, confidence, and procedural and technical skills before they start to care for patients. As other programs look to adopt this training method, medical educators must understand how novice trainees acquire new skills and thus why boot camps are effective. This chapter reviews theoretical principles from Motor Learning, Cognitive Psychology, and Education Science to explain the attentional demands of novice skill acquisition, what practice strategies promote novice learning, and how these can be applied in a boot camp setting. The goal of this chapter is to provide educators with information on how to be successful in the development and implementation of their own boot camps.

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References

  • Adams JA. A closed-loop theory of motor learning. J Mot Behav. 1971;3:111–49.

    Article  CAS  PubMed  Google Scholar 

  • Baddeley AD. Working memory. Oxford: Claredon; 1986.

    Google Scholar 

  • Bandura A. Perceived self-efficacy in cognitive development and functioning. Educ Psychol. 1993;28:117–48.

    Article  Google Scholar 

  • Battig WF. Facilitation and interference. In: Bilodeau EA, editor. Acquisition of skill. New York: Academic; 1966.

    Google Scholar 

  • Beilock SL, Carr T, MacMahon C, Starkes JL. When paying attention becomes counterproductive: impact of divided versus skill-focused attention on novice and experienced performance of sensorimotor skills. J Exp Psychol Appl. 2002a;8:6–16.

    Article  PubMed  Google Scholar 

  • Beilock SL, Wierenga SA, Carr TH. Expertise, attention, and memory in sensorimotor skill execution: impact of novel task constraints on dual-task performance and episodic memory. Q J Exp Psychol A. 2002b;55(4):1211–40.

    Article  PubMed  Google Scholar 

  • Blackmore C, Austine J, Lopushinsky SR, Donnon T. Effects of postgraduate medical education “boot camps” on clinical skills, knowledge, and confidence: a meta-analysis. J Grad Med Educ. 2014;6(4):643–52.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bligh J. The first year of doctoring: still a survival exercise. Med Educ. 2002;36:2–3.

    Article  PubMed  Google Scholar 

  • Cameron A, Millar J, Szmidt N, Hanlon K, Cleland J. Can new doctors be prepared for practice? A review. Clin Teach. 2014;11:188–92.

    Article  PubMed  Google Scholar 

  • Cave J, Woolf K, Jones A, Dacre J. Easing the transition from student to doctor: how can medical schools help prepare their students for starting work? Med Teach. 2009;31:403–8.

    Article  PubMed  Google Scholar 

  • Chiviacowsky S, Wulf G. Self-controlled feedback is effective if it is based on the learner’s performance. Motor Control Learn. 2002;76(1):42–8.

    Google Scholar 

  • Cohen ER, Barsuk JH, Moazed F, Caprio T, Didwania A, McGaghie WC, Wayne DB. Making July safer: simulation-based mastery learning during intern boot camp. Acad Med. 2013;88:233–9.

    Article  PubMed  Google Scholar 

  • Craik FIM, Lockhart RS. Levels of processing: a framework for memory research. J Verbal Learn Verbal Behav. 1972;11:671–81.

    Article  Google Scholar 

  • Craik FI, Govoni R, Naveh-Benjamin M, Anderson ND. The effects of divided attention on encoding and retrieval processes in human memory. J Exp Psychol. 1996;125(2):159–80.

    Article  CAS  Google Scholar 

  • Dubrowski A, Brydges R, Satterthwaite L, Xeroulis G, Classen R. Do not teach me while I am working! Am J Surg. 2012;203:253–7.

    Article  PubMed  Google Scholar 

  • Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(10):S70.

    Article  PubMed  Google Scholar 

  • Ericsson KA, Lehmann AC. Expert and exceptional performance: evidence of maximal adaption to task constraints. Annu Rev Psychol. 1996;47:273–305.

    Article  CAS  PubMed  Google Scholar 

  • Ericsson KA, Krampe RT, Tesch-Romer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993;100(3):363–406.

    Article  Google Scholar 

  • Ferguson PC, Kraemer R, Nousiainen M, Safir O, Sonnadara R, Alman B, Reznick R. Three-year experience with an innovative, modular competency-based curriculum for orthopaedic training. J Bone Joint Surg Am. 2013;95(21):e166(1)–6).

    Article  Google Scholar 

  • Fitts PM, Posner MI. Human performance. Belmont: Brooks/Cole; 1967.

    Google Scholar 

  • Gallese V, Fadiga L, Fogassi L, Rizzolatti G. Action recognition in the premotor cortex. Brain. 1996;119:593–609.

    Article  PubMed  Google Scholar 

  • Giordana A, Serra A. Learning from mistakes. Hum Mach Percept. 2001;3:89–102.

    Article  Google Scholar 

  • Gladwell M. Outliers: the story of success. 1st ed. New York: Little, Brown and Company; 2008.

    Google Scholar 

  • Haller G, Myles PS, TaffĂ© P, Perneger TV, Wu CL. Rate of undesirable events at beginning of academic year: retrospective cohort study. BMJ. 2009;339:b3974.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hebb DO. The organization of behavior. Hoboken: Wiley; 1949.

    Google Scholar 

  • Higbee K. Your memory how it works & how to improve it. 2nd ed. Cambridge: Da Capo Press; 1996.

    Google Scholar 

  • Janelle CM, Kim J, Singer RN. Subject-controlled performance feedback and learning of a closed motor skill. Percept Mot Skills. 1995;81:627–34.

    Article  CAS  PubMed  Google Scholar 

  • Keith N, Ericsson KA. A deliberate practice account of typing proficiency in everyday typists. J Exp Psychol. 2007;13(3):135–45.

    Google Scholar 

  • Lago-Rodriguez A, Lopez-Alonzo V, Fernández-del-Olmo M. Mirror neuron system and observational learning: behavioral and neurophysiological evidence. Behav Brain Res. 2013;248:104–13.

    Article  PubMed  Google Scholar 

  • Lee TD, Genovese ED. Distribution of practice in motor skill acquisition: learning and performance effects reconsidered. Res Q Exerc Sport. 1988;60:59–65.

    Article  Google Scholar 

  • Lee TD, Magill RA. The locus of contextual interference in motor skill acquisition. J Exp Psychol Learn Mem Cogn. 1983;9:730–46.

    Article  Google Scholar 

  • Lee TD, Wishart LD, Cunningham S, Carnahan H. Modeled timing information during random practice eliminates the contextual interference effect. Res Q Exerc Sport. 1997;68:100–5.

    Article  CAS  PubMed  Google Scholar 

  • Miller GA. The magical number seven plus or minus two: some limits on our capacity for processing information. Psychol Rev. 1956;63:81–97.

    Article  CAS  PubMed  Google Scholar 

  • Miller EK, Buschmann TJ. Working memory capacity: limits on the bandwidth of cognition. Daedalus. 2015;144(1):112–22.

    Article  Google Scholar 

  • Moulton C-AE, Dubrowski A, MacRae H, Graham B, Grober E, Reznick R. Teaching surgical skills: what kind of practice makes perfect? Ann Surg. 2006;244(3):400–9.

    PubMed  PubMed Central  Google Scholar 

  • Norman GA, Brooks LR, Allen SW. Recall by expert medical practitioners and novies as a record of processing attention. J Exp Psychol. 1989;15(6):1166–74.

    CAS  Google Scholar 

  • Prince KJA, Van de Weil M, van der Vleuten C, Boshuizen H, Scherpbier A. Junior doctors opinions about the transition from medical school to clinical practice: a change of environment. Educ Health. 2004;17:323–31.

    Article  Google Scholar 

  • Ramprasad A. On the definition of feedback. Behav Sci. 1983;28:4–13.

    Article  Google Scholar 

  • Reisberg D. Cognition exploring the science of the mind. 6th ed. New York: Norton; 2013.

    Google Scholar 

  • Rizzolatti G, Craighero L. The mirror-neuron system. Annu Rev Neurosci. 2004;27:169–92.

    Article  CAS  PubMed  Google Scholar 

  • Roberts NK, Williams RG, Kim MJ, Dunnington GL. The briefing, intraoperative teaching, debriefing model for teaching in the operating room. Am Coll Surg. 2009;208(2):299–303.

    Article  Google Scholar 

  • Roediger HL, Putnam AL, Smith MA. Ten benefits of testing and their applications to educational practice. In: Mestre J, Ross B, editors. Psychology of learning and motivation: cognition in education. Oxford: Elsevier; 2011. p. 55–36.

    Google Scholar 

  • Sadler R. Formative assessment and the design of instructional systems. Instr Sci. 1989;18:119–44.

    Article  Google Scholar 

  • Safir O, Williams CK, Dubrowski A, Backstein D, Carnahan H. Self-directed practice schedule enhances learning of suturing skills. Can J Surg. 2013;56(6):E142–e147.

    Article  PubMed  PubMed Central  Google Scholar 

  • Salmoni AW, Schmidt RL, Walter CB. Knowledge of results and motor learning: a review and critical appraisal. Psychol Bull. 1984;95(3):355–86.

    Article  CAS  PubMed  Google Scholar 

  • Schmidt RA. A schema theory of discrete motor skill learning. Psychol Rev. 1975;82:225–60.

    Article  Google Scholar 

  • Schmidt RA, Bjork RA. New conceptualizations of practice: common principles in three paradigms suggest new concepts for training. Psychol Sci. 1992;3:207–17.

    Article  Google Scholar 

  • Schmidt RA, Wrisberg CA. Motor learning and performance. Champaign: Human Kinetics; 2004.

    Google Scholar 

  • Shea JB, Morgan RL. Contextual interference effects on the acquisition, retention, and transfer of a motor skill. J Exp Psychol Hum Learn Mem. 1979;5:179–87.

    Article  Google Scholar 

  • Shea JB, Titzer RC. The influence of reminder trials on contextual interference effects. J Mot Behav. 1993;25:264–74.

    Article  CAS  PubMed  Google Scholar 

  • Shea CH, Wulf G, Whitacre CA. Enhancing training efficiency and effectiveness through the use of dyad training. J Mot Behav. 1999;31:119–25.

    Article  PubMed  Google Scholar 

  • Shebilske WL, Regian JW, Arthur W, Jordan JA. A dyadic protocol for training complex skills. Hum Factors. 1992;34:369–74.

    Article  Google Scholar 

  • Shors TJ, Matzel LD. Long-term potentiation: What’s learning got to do with it? Behav Brain Sci. 1997;20:597–655.

    PubMed  CAS  Google Scholar 

  • Sonnadara R, Van Vliet A, Safir O, Alman B, Ferguson P, Kraemer W, Reznick R. Orthopedic boot camp: examining the effectiveness of an intensive surgical skills course. Surgery. 2011;149(6):745–9.

    Article  PubMed  Google Scholar 

  • Sonnadara R, Garbedian S, Safir O, Nousiainen M, Alman B, Ferguson P, Kraemer W, Reznick R. Orthopaedic boot camp II: examining the retention rates of an intensive surgical skills course. Surgery. 2012;151(6):803–7.

    Article  PubMed  Google Scholar 

  • Sonnadara RR, Mui C, McQueen S, Mironova P, Nousiainen M, Safir O, Kraemer W, Ferguson P, Alman B, Reznick R. Reflections on competency-based education and training for surgical residents. J Surg Educ. 2014;71(1):151–8.

    Article  PubMed  Google Scholar 

  • Sweller J, Van Merrienboer JJG, Paas F. Cognitive architecture and instructional design. Educ Psychol Rev. 1998;10:251–96.

    Article  Google Scholar 

  • van Kesteren MT, Rijpkema M, Ruiter DJ, Morris RG, Fernández G. Building on prior knowledge: schema-dependent encoding processes relate to academic performance. J Cogn Neurosci. 2014;26(10):2250–61.

    Google Scholar 

  • Watkins D. Students’ perceptions of factors influencing tertiary learning. High Educ Res Dev. 1984;3:33–50.

    Article  Google Scholar 

  • Wulf G. Attention & motor skill learning. Champaign: Human Kinetics; 2007.

    Google Scholar 

  • Wulf G, Hob M, Prinz W. Instructions for motor learning: differential effects of internal versus external focus of attention. J Mot Behav. 1998;30:169–79.

    Article  CAS  PubMed  Google Scholar 

  • Wulf G, McNevin NH, Fuchs T, Ritter F, Toole T. Attentional focus in complex skill learning. Res Q Exerc Sport. 2000;71:229–39.

    Article  CAS  PubMed  Google Scholar 

  • Wulf G, McNevin NH, Shea CH, Wright DL. Learning phenomena: future challenges for the dynamical systems approach to understanding the learning of complex motor skills. Int J Sport Psychol. 2001;30:531–57.

    Google Scholar 

  • Young JQ, Ranji SR, Wachter RM, Lee CM, Niehaus B, Auerbach AD. “July effect”: impact of the academic year-end changeover on patient outcomes: a systematic review. Ann Intern Med. 2011;155:309–15.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, McMaster University, Hamilton, ON, Canada

    Natalie Wagner & Sydney McQueen

  2. Department of Surgery, Office of Education Science, McMaster University, Hamilton, ON, Canada

    Ranil Sonnadara

  3. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Ranil Sonnadara

Authors
  1. Natalie Wagner
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  2. Sydney McQueen
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  3. Ranil Sonnadara
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Corresponding author

Correspondence to Ranil Sonnadara .

Editor information

Editors and Affiliations

  1. Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada

    Oleg Safir

  2. Department of Surgery, Office of Education Science, McMaster University, Hamilton, Ontario, Canada

    Ranil Sonnadara

  3. Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Polina Mironova

  4. Department of Orthopaedic Surgery, United Lincolnshire Hospital, Boston, United Kingdom

    Rohit Rambani

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Wagner, N., McQueen, S., Sonnadara, R. (2018). Bridging the Gap: Theoretical Principles Behind Surgical Boot Camps. In: Safir, O., Sonnadara, R., Mironova, P., Rambani, R. (eds) Boot Camp Approach to Surgical Training. Springer, Cham. https://doi.org/10.1007/978-3-319-90518-1_1

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  • DOI: https://doi.org/10.1007/978-3-319-90518-1_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90517-4

  • Online ISBN: 978-3-319-90518-1

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