The Role of Anxiety in Simulation-Based Dexterity and Overall Performance: Does It Really Matter?
BACKGROUND
Essential Skills in the Management of Surgical Cases (ESMSC) is an international undergraduate surgical masterclass which combines ex vivo, dry lab and high fidelity in vivo simulation-based learning (SBL). It consists of 32 stations of skills-based learning, including open reduction internal fixation (ORIF) of fractures. Current literature suggests early involvement in skills-based learning at the undergraduate level is vital.


AIMS
To compare students' dexterity and skills-based performance with demographic and educational background parameters.


METHODS
112 medical students from European Union countries including the United Kingdom, Germany, Greece, Cyprus, Germany, and Bulgaria were selected from a competitive pool of candidates to attend the course. Students undertook ORIF in an ex vivo swine model, and in a simulated fracture on a bamboo rod. Skills-based performance was assessed by two consultant surgeons with validated direct observation of procedural skills (DOPS) forms. Anxiety was self-assessed using the Westside Anxiety Scale prior to the ORIF stations. Dexterity was measured with the O'Connor tweezer dexterity test.


RESULTS
Female students had significantly higher dexterity scores (median difference 7, p =.003). Right-handed students achieved higher dexterity than left-handed students (median difference 7, p =.043). There was no difference in students' performance across different medical schools, and across year groups (p <.05 for any correlation). Self-reported anxiety was not correlated with high fidelity skills-based performance (r = 0.032, p =.74).


CONCLUSION
Anxiety does not seem to play a significant role in Simulation Skills-Based learning. Undergraduate surgical curricula should incorporate SBL-based modules to enhance practical skills learning and motivate future orthopedic surgeons.
['Dhaif|Fatema|F|', 'Paparoidamis|Georgios|G|', 'Sideris|Michail|M|', 'Hanrahan|John|J|', 'Georgopoulou|Efstratia-Maria|EM|', 'Tsagkaraki|Ismini|I|', 'Staikoglou|Nikolaos|N|', 'Saeed|Ferha|F|', 'Michail|Theodoros|T|', 'Tzavelas|Anastasios|A|', 'Kenanidis|Efstathios|E|', 'Potoupnis|Michael|M|', 'Tsiridis|Eleftherios|E|', 'Papalois|Apostolos|A|']
D000818:Animals D001007:Anxiety D002983:Clinical Competence D004521:Educational Measurement D005260:Female D005858:Germany D006115:Greece D013552:Swine D006113:United Kingdom
dexterity simulation-based learning undergraduate surgical education