Preoperative priming results in improved operative performance with surgical trainees

Background: Preoperative warm-up regimens are increasingly utilised in the surgical field, however no consensus on benefits of priming across surgical experience has been realised. The aim of this study was to evaluate the impact of simulation preoperative priming on operative performance across levels of resident experience. Methods: A single-blinded randomised control trial was carried out in a regional surgical training centre. Vol-unteers were randomised to undergo simulated surgical warm-up procedure prior to their first case as primary operator or proceed directly to surgery. Results: Performances of 147 operative procedures were collected over an 18 month period, experience ranging from PGY2-PGY 7. Senior participants consistently outperformed junior residents in unprimed operative cases (p = 0.005). In primed operative performances no significant difference in aggregate performance scores was found (p = 0.07). Conclusion: Priming confers a greater advantage to junior residents with particular regard to generic surgical skills. Senior residents demonstrate improved self-efficacy scores measured following priming.