Determining the Effect of External Stressors on Laparoscopic Skills and Performance Between Obstetrics and Gynecology Residents

Moawad, Gaby; Tyan, Paul; Kumar, Dipti; Krapf, Jill M.; Marfori, Cherie Q.; Khalil, Elias D. Abi; Robinson, James K.

doi:10.1016/j.jsurg.2017.03.001

Cited by 8 publications

(14 citation statements)

References 15 publications

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“…Stress in the theater setting is believed to greatly influence surgical performance and task execution (9). Increased stress has been shown to negatively effect cognitive functioning, information processing and skills based surgical motion leading to detrimental affects on surgical performance and patient safety (9,18). High levels of stress have been shown to impair judgment, decision-making, and communication among trainee surgeons (18).…”

Section: Discussionmentioning

confidence: 99%

“…Increased stress has been shown to negatively effect cognitive functioning, information processing and skills based surgical motion leading to detrimental affects on surgical performance and patient safety (9,18). High levels of stress have been shown to impair judgment, decision-making, and communication among trainee surgeons (18). Stress in theater has been described as a dynamic phenomenon where a stress cascade occurs with adverse or stress inducing factors leading to progressive stress levels (20).…”

Section: Discussionmentioning

confidence: 99%

“…In the literature various distractions encountered in theater have been described such as, case irrelevant communication, equipment issues, phone calls/bleeps, movement and procedural issues (17). Distraction has been shown to be detrimental to numerous objective measurements of surgical proficiency, accuracy and TTC, ultimately translating into poorer patient outcomes in the real operating theater (14)(15)(16)(17)(18)25). The effects of distraction can be dependent on task difficulty (17).…”

Section: Discussionmentioning

confidence: 99%

“…This is reflected in the growing body of literature advocating movement toward the incorporation and training of cognitive and mental skills curricula focusing on the nontechnical skills that aid and often enhance technical surgical skill and performance (9,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The role of stress, as well as cognitive distraction, and their impact in impairing technical performance is well documented (9,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Operating room distractions and interruptions (ORDIs) are widely acknowledged as part of the theater environment and relate specifically to occasions where the attention of one or more of the surgical team is drawn away from the primary task toward a less important or case irrelevant task (14).…”

Section: Introductionmentioning

confidence: 99%

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Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance

et al. 2020

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Introduction: Microsurgery is an essential element of Plastic Surgery practice. There is a paucity of studies assessing the impact of stress and cognitive distraction on technical microsurgical performance. The ability to complete cognitive and technical skills in parallel has not been assessed in a microsurgical setting. Aim: To test the hypothesis that cognitive distraction and external stressors negatively affect microsurgical performance in a high fidelity simulation setting. Materials/Methods: Fourteen surgeons across all levels of training undertook 2 microsurgical skills sessions, 1 month apart. Session one established baseline microsurgical skill. In session two, skills were assessed with the introduction of realistic operative room cognitive distractions (ORDIs). Outcome measures were efficiency and accuracy, measured by Time to Completion (TTC) and Anastomosis Lapse Index (ALI), respectively. Key Results: Fourteen participants (6 novices, 5 plastic surgery specialist trainees and 3 consultants) completed both microsurgical skills sessions. In total, 28-microvascular anastomosis were analyzed. Mean baseline TTC for the group was 20.36 min. With cognitive distraction and external stress mean TTC decreased to 17.87 min. Mean baseline ALI score for the group was 3.32 errors per anastomosis. The introduction of cognitive distraction and external stress increased the mean to 4.86 errors per anastomosis. Total errors per anastomosis increased from 91 errors at baseline to 137 errors with cognitive distraction and external stress. Under stress, participants were more efficient but had reduced anastomotic accuracy. Conclusion: Under stress, surgeons were more efficient, this translated into faster completion of a microsurgical anastomosis. Efficiency, however, came at the expense of accuracy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance

et al. 2020

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“…Despite the evidence reported in the literature, in many countries, medical residency programs aiming at providing basic introductory training in diagnostic laparoscopy do not integrate as part of the curriculum. In countries were those programs were implemented there is no standardized training adopted leading to a very heterogeneous formation of future professionals 24 - 26 .…”

Section: Discussionmentioning

confidence: 99%

The role of laparoscopy in the propaedeutics of gynecological diagnosis

et al. 2019

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Purpose To evaluate agreement between pre- and post-laparoscopy gynecological diagnosis in order to demonstrate the rationality of this minimally invasive technique use in gynecological propaedeutics. Methods Retrospective chart review study conducted between March 2010 and October 2016 based on a convenience sample. 315 patients undergoing surgical laparoscopy at the Center of Gynecologic Endoscopy and Family Planning of Botucatu Medical School/UNESP. Pre- and postoperative diagnoses were compared by the diagnosis agreement test considering the proportions of events. Results Laparoscopy contributed to diagnosis in 59.6% of infertility cases (P>0.05), in 93.7% of chronic pelvic pain of undetermined origin (P<0.01) and conclusively elucidated the diagnosis of acute abdomen and the ruling out of tubo-ovarian abcess (P<0.05). Laparoscopy also increased the diagnosis of pelvic-abdominal adhesions in 76.7% (P>0.05). Conclusion The use of laparoscopy considerably contributed to diagnostic elucidation, especially in cases of undetermined chronic pelvic pain.

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“Don’t Yell at Me!” Disruptive Behavior in the OR

Coleman,

Schulick

2024

Principles of Perioperative Safety and Efficiency

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Determining the Effect of External Stressors on Laparoscopic Skills and Performance Between Obstetrics and Gynecology Residents

Cited by 8 publications

References 15 publications

Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance

Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance

The role of laparoscopy in the propaedeutics of gynecological diagnosis

“Don’t Yell at Me!” Disruptive Behavior in the OR

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