The influence of positive and negative intraoperative feedback in laparoscopic simulation in pediatric urology training

Abstract

Background and objective: This study aimed to explore the impact of positive or negative feedback on the performance of trainees in pediatric urology during simulation exercises in pediatric laparoscopy.

Methods: Twenty-five students enrolled in a national Pediatric Urology Laparoscopy Simulation participated in the study. They performed the Fundamentals of Laparoscopic Surgery (FLS) skills, specifically peg-transfer and intracorporeal knot-tying, in a randomized study design while receiving positive or negative feedback from an attending pediatric urologist. On the first day, all students performed FLS peg-transfer and intracorporeal knot-tying tasks on a pediatric laparoscopic simulator. On the second day, students were randomized to receive either positive or negative comments during the procedure. Task performances, measured by task time and errors, was compared between both groups. Statistical analysis was conducted using the Mann-Whitney U test.

Key findings and limitations: The difference in execution time between exercises with and without feedback was significantly greater in the group that received negative feedback compared to the group that received positive feedback (p = 0.003). Students who received positive feedback increased their time by a median of 2 s, whereas students who received negative comments increased their time by a median of 34 s.

Conclusions and clinical implications: Feedback should be delivered in a manner that is supportive, respectful, and improvement-focused rather than discouragement. Understanding these dynamics can guide the development of effective feedback strategies to optimize learning and enhance performance outcomes in training for minimally invasive surgery in pediatric urology.

Keywords: Education; Feedback; Laparoscopy; Medical; Pediatric urology; Simulation training.