Abstract:
Traditional methods of surgical skill-learning tend to take the form of impromptu hands-on teaching, mainly through explicit learning. In explicit learning, skills are learnt via trial and error, and there is a significant amount of time spent learning and correcting movements until a skill is mastered. In contrast, an alternative form of learning, implicit learning, is the antithesis of the above. Currently, a small amount of literature supports the introduction of implicit learning to the health sector (dentistry and laparoscopic surgery). One method of encouraging implicit processes is to reduce errors in the initial learning of a novel motor task.
The research presented here compares implicit (errorless) learning versus explicit (error-ful) learning in the development of skills with high-speed burr in tasks that simulate cervical laminoplasty. This is the first study to investigate the application of implicit learning principles to spine surgery education. In addition, this study seeks to contribute to evidence for a potential alternative, sustainable means to train surgeons in the future.
The results from this project did not show a significant difference in performance scores or time to the completion of surgical tasks following either errorless or error-ful learning. However, it has demonstrated that skills learnt were transferrable between initial learning tasks to performing a simulated laminoplasty. Further research is needed to confirm a suitable implicit learning protocol for use in surgical training. Advancement in this field is relevant and important in contemporary practice, where 'hands-on' learning opportunities in the clinical context may become limited.
