The relationship of praise/criticism to learning during obstetrical simulation: a randomized clinical trial

Abstract Aims: The effect of positive vs. negative comments (praise vs. criticism) on trainees’ subsequent cognitive and technical performance is unknown, but of potential importance. We performed a randomized trial of giving either praise or criticism during simulated normal vaginal deliveries (using a high-fidelity birthing simulator) to assess the differential effect of these types of comments on students’ cognitive and technical performance, and perceived confidence after their learning experience. Methods: Medical and nursing students underwent stratified randomization to praise or criticism. Students (n=59) initially participated in a teaching demonstration and practiced normal spontaneous vaginal delivery using a birthing simulator. A baseline assessment of cognitive and technical skills, and of self-confidence, was followed by a second simulation during which positive or negative comments were given using standardized scripts. Cognitive performance, technical performance and confidence measures were then scored again. Results: Cognitive and technical performance scores in the “praise” group improved significantly by 2.5 (P=0.007) and 1.8 (P=0.032), respectively, while those in the “criticism” group remained unchanged. The self-reported confidence scores did not show any significant change from baseline in either group. Conclusions: Praise strengthens students’ cognitive and technical performances, while criticism does not.

[1]  V. Kopp,et al.  High-fidelity simulation increases obstetric self-assurance and skills in undergraduate medical students , 2012, Journal of perinatal medicine.

[2]  Amy L. Seybert,et al.  Comparing Effectiveness of 3 Learning Strategies: Simulation-Based Learning, Problem-Based Learning, and Standardized Patients , 2012, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[3]  Gary P. Latham,et al.  Work Motivation: History, Theory, Research, and Practice , 2011 .

[4]  Michael Dell,et al.  Getting Beyond “Good Job”: How to Give Effective Feedback , 2011, Pediatrics.

[5]  G. Seijts,et al.  The effect of negative feedback on tension and subsequent performance: the main and interactive effects of goal content and conscientiousness. , 2010, The Journal of applied psychology.

[6]  M. Joëls,et al.  Severe Early Life Stress Hampers Spatial Learning and Neurogenesis, but Improves Hippocampal Synaptic Plasticity and Emotional Learning under High-Stress Conditions in Adulthood , 2010, The Journal of Neuroscience.

[7]  N. Katz,et al.  Simulation Training Improves Medical Students’ Learning Experiences When Performing Real Vaginal Deliveries , 2009, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[8]  Beat Meier,et al.  Stress Effects on Working Memory, Explicit Memory, and Implicit Memory for Neutral and Emotional Stimuli in Healthy Men , 2008, Frontiers in behavioral neuroscience.

[9]  M. Berner,et al.  Effect of crew resource management training in a multidisciplinary obstetrical setting. , 2008, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[10]  R. Fox,et al.  Hospital, Simulation Center, and Teamwork Training for Eclampsia Management: A Randomized Controlled Trial , 2008, Obstetrics and gynecology.

[11]  H. Wehbe-Janek,et al.  Ob/Gyn Boot Camp Using High-Fidelity Human Simulators: Enhancing Residents’ Perceived Competency, Confidence in Taking a Leadership Role, and Stress Hardiness , 2008, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[12]  Robert Fox,et al.  Training for Shoulder Dystocia: A Trial of Simulation Using Low-Fidelity and High-Fidelity Mannequins , 2006, Obstetrics and gynecology.

[13]  Shad Deering,et al.  Simulation Training and Resident Performance of Singleton Vaginal Breech Delivery , 2006, Obstetrics and gynecology.

[14]  D. M. Elnicki,et al.  Learning/Feedback Activities and High-Quality Teaching: Perceptions of Third-Year Medical Students during an Inpatient Rotation , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[15]  Remus Ilies,et al.  Goal regulation across time: the effects of feedback and affect. , 2005, The Journal of applied psychology.

[16]  B. McEwen.  Early life influences on life-long patterns of behavior and health. , 2003, Mental retardation and developmental disabilities research reviews.

[17]  A. Bandura.  Self-Efficacy: The Exercise of Control , 1997, Journal of Cognitive Psychotherapy.

[18]  R. Mcintyre,et al.  A Conceptual Framework for Teamwork Measurement , 1997 .

[19]  A. Kluger,et al.  The effects of feedback interventions on performance: A historical review, a meta-analysis, and a preliminary feedback intervention theory. , 1996 .

[20]  E. A. Locke,et al.  A theory of goal setting & task performance , 1990 .

[21]  H. Klein,et al.  An Integrated Control Theory Model of Work Motivation , 1989 .

[22]  D Zakay,et al.  Time pressure, training and decision effectiveness. , 1984, Ergonomics.

[23]  A. Bandura,et al.  Self-evaluative and self-efficacy mechanisms governing the motivational effects of goal systems. , 1983 .

[24]  J. Ende.  Feedback in clinical medical education. , 1983, JAMA.

[25]  G. Schneider.  Management of normal labour and delivery in the case room: a critical appraisal. , 1981, Canadian Medical Association journal.

[26]  D. Kirkpatrick.  Techniques for evaluating training programs , 1979 .