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Introduction: Several studies demonstrated that simulator-acquired skill transfer to the operating room is incomplete. Our objective was to identify trainee characteristics that predict the transfer of simulatoracquired skill to the operating room.

Methods: Trainees completed baseline assessments including intracorporeal suturing (IS) performance, attentional selectivity, self-reported use of mental skills, and self-reported prior clinical and simulated laparoscopic experience and confidence. Residents then followed proficiency-based laparoscopic skills training, and their skill transfer was assessed on a live-anesthetized porcine model. Predictive characteristics for transfer test performance were assessed using multiple linear regression.

Results: Thirty-eight residents completed the study. Automaticity, attentional selectivity, resident perceived ability with laparoscopy and simulators, and post-training IS performance were predictive of IS performance during the transfer test.

Conclusions: Promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. Mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal.

The transfer of simulator-acquired surgical skill to the clinical environment is incomplete, thus, the purpose of the current study was to assess which trainee characteristics predict the transfer of simulator-acquired laparoscopic skill to the operating room. Residents' automaticity, perceived ability in laparoscopic surgery and perceived ability on simulators, and attentional selectivity predict transfer of simulator-acquired suturing skill to suturing performance on a live porcine Nissen model. Mental skills training and training to automaticity may ensure the more complete transfer of trainees’ simulator-acquired skill to the clinical environment.

1. simulation to clinical transfer is incomplete –> what predicts it?
2. why is transfer incomplete?
   1. stress: Additional research in this area has identified that the clinical environment may cause increased stress which prevents the complete transfer of simulator acquired skill.(8)“
   2. but there must be others, including incompleteness of the simulator
3. Domain/ model
   1. laparascopic surgery

Anton, N. E., Mizota, T., Timsina, L. R., Whiteside, J. A., Myers, E. M., & Stefanidis, D. (2019). Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment. The American Journal of Surgery, 217(2), 266–271. https://doi.org/10.1016/j.amjsurg.2018.11.028