Do novices display automaticity during simulator training

Background The objective of this study was to investigate whether novices improve their ability to develop multitask (ie, automaticity) with accumulating experience on a simulated laparoscopic task. Methods In this prospective study, novices (12 premed students) trained for 4 months in laparoscopic suturing. Simultaneously with suturing, participants performed a visual–spatial secondary task to assess their spare attentional capacity. Trainees were required to achieve expert-derived levels in both suturing (520 score) and the secondary task (target 73%). Their performance was assessed with objective scores, and their ability to multitask during training was examined. Results After 10 ± 5 hours and 84 ± 41 repetitions, participants demonstrated improvements in their suturing (70%, P < 0.001) and secondary-task performance (16%, P = 0.08) compared with their baseline scores. During the study period, 11 of 12 participants achieved suturing proficiency, but no one achieved secondary-task proficiency. Longer training times correlated with higher secondary-task scores (r = .68, P < 0.02), and participants who performed >100 repetitions (n = 4) achieved higher secondary-task scores (P < 0.03). Comments This study provides evidence for improved automaticity at advanced stages of simulator training. Although novices achieve simulator proficiency after relatively short training durations, the attainment of automaticity requires substantially longer training periods. Further study of this concept is warranted and is currently underway.