Intra-operative disruptions, surgeon’s mental workload, and technical performance in a full-scale simulated procedure

Weigl, Matthias; Stefan, Philipp; Abhari, Kamyar; Wucherer, Patrick; Fallavollita, Pascal; Lazarovici, Marc; Weidert, Simon; Euler, Ekkehard; Catchpole, Ken

doi:10.1007/s00464-015-4239-1

Cited by 75 publications

(61 citation statements)

References 36 publications

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“…Despite more than 550 studies using NASA‐TLX reported in the past 20 years, few have proposed the workload redline when using this tool – a point on the scale that indicates when the workload is considered so high that it may affect human performance. A modified version of NASA‐TLX was developed and validated specifically to capture the surgical context, the Surgery Task Load Index (SURG‐TLX). In two of the reviewed studies, the NASA‐TLX questionnaire was used to capture surgeons' cognitive load over repeated training sessions, and correlated with technical performance and errors.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of measurement tools to assess surgeons' intraoperative cognitive workload

Dias

Ngo-Howard

Boskovski

et al. 2018

British Journal of Surgery

145

140

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Self-report instruments are valuable when the aim is to assess the overall cognitive load in different surgical procedures and assess learning curves within competence-based surgical education. When the aim is to assess cognitive load related to specific operative stages, real-time tools should be used, as they allow capture of cognitive load fluctuation. A combination of both subjective and objective methods might provide optimal measurement of surgeons' cognition.

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Section: Resultsmentioning

confidence: 99%

Systematic review of measurement tools to assess surgeons' intraoperative cognitive workload

Dias

Ngo-Howard

Boskovski

et al. 2018

British Journal of Surgery

145

140

View full text Add to dashboard Cite

show abstract

“…Such events have been defined as flow disruptions, or ‘deviations from the natural progression of an operation, thereby potentially compromising the safety of the operation’ . Flow disruptions have been shown to increase mental workload and the likelihood of surgical errors .…”

Section: Introductionmentioning

confidence: 99%

Identifying workflow disruptions in the cardiovascular operating room

et al. 2016

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SummaryThe objectives of this study were to identify the frequency and nature of flow disruptions in the operating room with respect to three cardiac surgical team members: anaesthetists; circulating nurses; and perfusionists. Data collected from 15 cases and coded using a human factors taxonomy identified 878 disruptions. Significant differences were identified in frequency relative to discipline type. Circulating nurses experienced more coordination disruptions (v 2 (2, N = 110) = 7.136, p < 0.028) and interruptions (v 2 (2, N = 427) = 29.743, p = 0.001) than anaesthetists and perfusionists, whereas anaesthetists and perfusionists experienced more layout issues than circulating nurses (v 2 (2, N = 153) = 48.558, p = 0.001). Time to resolve disruptions also varied among disciplines (k (12, 878) = 5.186, p = 0.000). Although most investigations take a one-size fits all approach in addressing disruptions to flow, this study demonstrates that targeted interventions must focus on differences with respect to individual role.

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“…types. In addition, if more data are available in future, the effects of other factors might be investigated, such as turnover time [24], interruptions [25][26][27], and surgeon experience [28,29], since these factors have been found to affect the surgical quality. Additionally, the fact that a surgeon working faster (or slower) does not mean that he/she is better (or worse) at the surgeries.…”

Section: Limitations Of the Studymentioning

confidence: 99%

Clinical and Nonclinical Effects on Operative Duration: Evidence from a Database on Thoracic Surgery

Wang

Cabrera

Tsui

et al. 2020

Journal of Healthcare Engineering

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Background. Due to the high maintenance costs, it is critical to make full use of operating rooms (ORs). Operative duration is an important factor that guides research on surgery scheduling. Clinical effects, for example, surgery type, rationally influences operative duration. In this study, we also investigate whether the planning and scheduling decisions in ORs influence the operative duration. Methods. For our study, we collected and reviewed data on 2,451 thoracic operations from a large hospital in China. The study was conducted over a period of 34 months. Linear and nonlinear regression models were used to detect the effects on the duration of the operations. We have also examined interactions between the factors. Results. Operative duration decreased with the number of operations a surgeon performed in a day (P<0.001). It was also found that operative duration decreased with the number of operations allocated to an OR, as long as there were not more than four surgeries per day (P<0.001). However, they increased with the number of operations if it was more than four (P<0.01). The duration of surgery was affected by its position in the sequencing of surgeries performed by a surgeon. In addition, the effects of surgeons depend on the surgery type as well as the position in the sequencing order. Conclusions. Operative duration was affected not only due to clinical effects but also some nonclinical effects. Scheduling decisions significantly influenced operative duration.

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Intra-operative disruptions, surgeon’s mental workload, and technical performance in a full-scale simulated procedure

Cited by 75 publications

References 36 publications

Systematic review of measurement tools to assess surgeons' intraoperative cognitive workload

Systematic review of measurement tools to assess surgeons' intraoperative cognitive workload

Identifying workflow disruptions in the cardiovascular operating room

Clinical and Nonclinical Effects on Operative Duration: Evidence from a Database on Thoracic Surgery

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