Employing cognitive task analysis supported instruction to increase medical student and surgical resident performance and self-efficacy

Cognitive task analysis (CTA) is a powerful tool for eliciting expert knowledge to enhance training practices. While CTA methods have been employed successfully to design surgical skills training to improve performance, the effects of CTA supported instruction on self-efficacy have yet to be examined. This study explores the effects of a CTA instructional intervention on surgical skills performance and self-efficacy beliefs for conducting an open cricothyrotomy procedure. Self-efficacy beliefs are important for educators to consider because they influence performance, decision making, and motivation. Instruction focused on mastery learning, such as CTA supported instruction, positively influences self-efficacy beliefs. The purpose of this study is to determine if CTA instruction has an effect on self-efficacy and performance. This study compares CTA supported instruction and expert-guided instruction used to teach medical students and postgraduate surgical residents an open cricothyrotomy procedure at a medical research university surgical skills lab. Education level and gender are considered for their potential effects on self-efficacy and performance. Results indicate that CTA supported instruction had significant positive effects on overall performance outcomes and the self-efficacy ratings for the experimental group. Gender did not have an effect on self-efficacy ratings; education level had significant effects on self-efficacy ratings, but not performance. Implications for future CTA efforts and research are discussed.