Fast or safe? The role of impulsiveness in laparoscopic simulator performance

Abstract

Background: Little is known about the relation between impulsiveness and surgical performance even though research in similar high-risk/high-skills shows evidence of more hazardous behavior by impulsive professionals. We investigated the impact of impulsiveness on laparoscopic simulator performance. Methods: Eighty-three subjects participated in a four-session laparoscopic training course. Based on the Eysenck Personality test, we created equal sized high-and low impulsiveness groups and compared task duration and errors on tasks for two laparoscopic simulators. Results: The low impulsiveness group outperformed the high impulsiveness group on damage on the LapSim virtual reality trainer (U ¼ 459, p < .049), and showed a trend towards better error performance on the FLS videotrainer. We found no differences on task duration. Conclusions: In surgical simulation training, high impulsiveness is associated with creating more damage, but not with faster performance. Time needed to correct errors may have obscured faster performance in the high impulsiveness group. Summary for the table of contents: Subjects were divided into high-and low impulsiveness groups based on the Eysenck Impulsiveness Inventory test. Performance (time and errors) were compared between groups for tasks on the LapSim virtual reality trainer and FLS videotrainer. Low impulsive subjects outperformed high impulsive subjects on errors.

Encouraging Young Pediatric Surgeons and Evaluation of the Effectiveness of a Pediatric Endosurgery Workshop by Self-assessment and an Objective Skill Validation System: The Japan-Russia Medical Cooperation Project

“…Differences in surgical skill between expert surgeons and novice surgeons appear in the difference in their forceps handling during endoscopic surgery [13], it seems that considerable time and experience are required to improve a surgeon's forceps handling. In a study examining the relationship between quick forceps handling and surgical performance [14], rough and quick handling of the forceps is associated with creating more organ damage, but not faster performance. In short, slow manipulation of the forceps ("zero" speed of acceleration) results in the performance of safe and secure endoscopic surgery in comparison to rough and quick manipulation of the forceps.…”

Speed versus damage: using selective feedback to modulate laparoscopic simulator performance

“…In earlier research we established the effect of impulsiveness on laparoscopic simulator performance [ 4 ]. High-impulsiveness students created more damage but were not faster in various basic skills tasks.…”

“…We are only starting to understand the relations between individual differences and surgical performance. We have begun to study impulsiveness, relevant for damage control [ 4 , 7 – 12 , 46 ], but other individual differences need to be taken into account as well. Personality includes more aspects than just impulsiveness which need to be investigated.…”

“…Personality is a major source of differences in behavior between people [ 1 – 3 ]. Emerging research is highlighting differences in personality between surgeons and controls; in these studies surgeons typically show heightened extraversion [ 4 – 6 ]. In traffic and in high-skilled professions such as pilots, the related personality trait of impulsiveness has been shown to correlate with dangerous behavior [ 7 – 12 ].…”

“…Patients may be at risk if a similar association is present in the operating room. In a previous simulator-based laparoscopic training study, we found that high-impulsiveness trainees created more damage in comparison to low-impulsiveness trainees but were equally fast [ 4 ]. An adaptive training approach, already used in military medical skills acquisition and retention, to effectively train personnel of different skills levels [ 13 ], could potentially counteract the negative effects associated with high impulsiveness.…”