Speed and quality goals in procedural skills learning: A randomized experiment

Med Teach. 2020 Feb;42(2):196-203. doi: 10.1080/0142159X.2019.1670342. Epub 2019 Oct 9.

Abstract

Purpose: Compare time (speed) and product quality goals in a surgical procedural task.Methods: Secondary school students participating in a medical simulation-based training activity participated in a randomized experiment. Each participant completed eight repetitions of a blood vessel ligation. Once, between repetitions four and five, each participant received a randomly-assigned speed goal or quality goal. Outcomes included time and leak-free ligatures.Results: 80 students participated. The speed-goal group performed 18% faster on the final repetition than the quality-goal group, with adjusted fold change (FC) 0.82 (95% confidence interval [CI], 0.71, 0.94; p = 0.01). Conversely, the speed-goal group had fewer high-quality (leak-free) ligatures (odds ratio [OR] 0.36 [95% CI, 0.22, 0.58; p < 0.001]). For the quality-goal group, leaky ligatures took longer post-intervention than leak-free ligatures (FC 1.09 [95% CI, 1.02, 1.17; p = 0.01]), whereas average times for leaky and leak-free ligatures were similar for the speed-goal group (FC 0.97 [95% CI, 0.91, 1.04; p = 0.38]). For a given performance time, the speed-goal group had more leaks post-intervention than the quality-goal group (OR 3.35 [95% CI, 1.58, 7.10; p = 0.002]).Conclusions: Speed and quality goals promote different learning processes and outcomes among novices. Use of both speed and quality goals may facilitate more effective and efficient learning.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Blood Vessels
  • Clinical Competence
  • Female
  • Goals*
  • Humans
  • Learning
  • Male
  • Quality of Health Care*
  • Schools
  • Simulation Training
  • Students
  • Task Performance and Analysis
  • Time
  • Treatment Outcome
  • Vascular Surgical Procedures / education*
  • Vascular Surgical Procedures / standards*