Optimizing learner engagement during mental skills training: A pilot study of small group vs. individualized training

Anton, Nicholas E.; Bean, Eric; Myers, Erinn M.; Stefanidis, Dimitrios

doi:10.1016/j.amjsurg.2019.12.022

Cited by 10 publications

(17 citation statements)

References 23 publications

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“…We believe that spatio-temporal patterns of psychophysiological stress, recorded during different stages of surgical procedures, need to be compared with those of expert surgeons for mastering surgical skill acquisition. This real-time monitoring of acute mental stress from surgeons and surgical staff in the OR may also help to: (a) predict periods of high stress, (b) analyze effects of novel image-guided and minimally invasive surgical techniques on workload, stress, anxiety, and technical skills in real and simulated surgeries [37]- [40], (c) accelerate implementation of stress-management interventions to reduce occupational stress and improve clinical outcomes and patients' well-being [41]- [44], (d) introduce mental skill training and multi-session monitoring of skill acquisition in trainees [45]- [47], (e) improve surgical automaticity and performance [7], [17], [48], and (f) develop intelligent surgical assistance in smart ORs [36], [49].…”

Section: And Anecdotes Have Shown That Expertmentioning

confidence: 99%

Methods and Measures for Mental Stress Assessment in Surgery: A Systematic Review of 20 Years of Literature

Torkamani-Azar

Lee

Bednarik

2022

IEEE J. Biomed. Health Inform.

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Real-time mental stress monitoring from surgeons and surgical staff in operating rooms may reduce surgical injuries, improve performance and quality of medical care, and accelerate implementation of stressmanagement strategies. Motivated by the increase in usage of objective and subjective metrics for cognitive monitoring and by the gap in reviews of experimental design setups and data analytics, a systematic review of 71 studies on mental stress and workload measurement in surgical settings, published in 2001-2020, is presented. Almost 61% of selected papers used both objective and subjective measures, followed by 25% that only administered subjective tools -mostly consisting of validated instruments and customized surveys. An overall increase in the total number of publications on intraoperative stress assessment was observed from mid-2010 s along with a momentum in the use of both subjective and real-time objective measures. Cardiac activity, including heart-rate variability metrics, stress hormones, and eye-tracking metrics were the most frequently and electroencephalography (EEG) was the least frequently used objective measures. Around 40% of selected papers collected at least two objective measures, 41% used wearable devices, 23% performed synchronization and annotation, and 76% conducted baseline or multipoint data acquisition. Furthermore, 93% used a variety of statistical techniques, 14% applied regression models, and only one study released a public, anonymized dataset. This review of data modalities, experimental setups, and analysis techniques for intraoperative stress monitoring highlights the initiatives of surgical data science and motivates research on computational techniques for mental and surgical skills assessment and cognition-guided surgery.

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Section: And Anecdotes Have Shown That Expertmentioning

confidence: 99%

Methods and Measures for Mental Stress Assessment in Surgery: A Systematic Review of 20 Years of Literature

Torkamani-Azar

Lee

Bednarik

2022

IEEE J. Biomed. Health Inform.

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“…The technologies were applied in studies involving simulation-based tasks with i.e., box trainers, VR simulators, robotic surgical simulators, and other technologies, in addition to real interventions. HR was used in [ 15 , 23 , 24 , 59 – 61 , 67 , 69 – 74 , 76 , 81 – 89 ], while articles where HRV metrics were used are described in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Other stress scales were used in 4 articles. Specifically, the Short Stress State Questionnaire (SSSQ [ 89 , 114 ]), the Depression, Anxiety and Stress Scale (DASS [ 115 ]) [ 92 ], the Trier Social Stress Test (TSST [ 61 , 116 ]), and the Mental Readiness Form (MRF [ 88 , 117 ]). Additionally, 5-point non-validated Likert scales were used in [ 78 , 118 ].…”

Section: Resultsmentioning

confidence: 99%

Stress in surgical educational environments: a systematic review

et al. 2022

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Background The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in surgical stress management training, and (3) how stress affects surgical performance. Methods A search strategy was implemented to retrieve relevant articles from Web of Science, Scopus, and PubMed. The 787 initially retrieved articles were reviewed for further evaluation according to the inclusion/exclusion criteria (Prospero registration number CRD42021252682). Results Sixty-one articles were included in the review. The stress monitoring methods found in the articles showed heart rate analysis as the most used monitoring tool for physiological parameters while the STAI-6 scale was preferred for psychological parameters. The stress management methods found in the articles were mental-, simulation- and feedback-based training, with the mental-based training showing clear positive effects on participants. The studies analyzing the effects of stress on surgical performance showed both negative and positive effects on technical and non-technical performance. Conclusions The impact of stress responses presents an important factor in surgical environments, affecting residents’ training and performance. This study identified the main methods used for monitoring stress parameters in surgical educational environments. The applied surgical stress management training methods were diverse and demonstrated positive effects on surgeons’ stress levels and performance. There were negative and positive effects of stress on surgical performance, although a collective pattern on their effects was not clear.

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“…The review identified 20 relevant studies; six targeted open clinical skills (Wetzel et al 2011;Ignacio et al 2016;Lorello et al 2016;Ignacio et al 2017;Goldberg et al 2018;Church 2019) and 14 targeted closed clinical skills (Immenroth et al 2007;Wright et al 2008;Arora et al 2011;Hunziker et al 2013;Maher et al 2013;Anton, Mulji, et al 2017;Stefanidis, Anton, McRary, et al 2017;Anton et al 2018Anton et al , 2019Anton et al , 2020Raison et al 2018 The extent of PMST in HPE As Supplement Table 1 shows, the majority of the studies were from the United States of America (n ¼ 10) and the United Kingdom (n ¼ 5), with 14 studies on closed CS and six studies on open CS.…”

Section: Resultsmentioning

confidence: 99%

Applying sport psychology in health professions education: A systematic review of performance mental skills training

et al. 2021

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Introduction: Health professionals are expected to consistently perform to a high standard during a variety of challenging clinical situations, which can provoke stress and impair their performance. There is increasing interest in applying sport psychology training using performance mental skills (PMS) immediately before and during performance. Methods: A systematic review of the main relevant databases was conducted with the aim to identify how PMS training (PMST) has been applied in health professions education and its outcomes. Results: The 20 selected studies noted the potential for PMST to improve performance, especially for simulated situations. The key implementation components were a multimodal approach that targeted several PMS in combination and delivered face-to-face delivery in a group by a trainer with expertise in PMS. The average number of sessions was 5 and of 57 min duration, with structured learner guidance, an opportunity for practice of the PMS and a focus on application for transfer to another context. Conclusion: Future PMST can be informed by the key implementation components identified in the review but further design and development research is essential to close the gap in current understanding of the effectiveness of PMST and its key implementation components, especially in real-life situations.

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Optimizing learner engagement during mental skills training: A pilot study of small group vs. individualized training

Cited by 10 publications

References 23 publications

Methods and Measures for Mental Stress Assessment in Surgery: A Systematic Review of 20 Years of Literature

Methods and Measures for Mental Stress Assessment in Surgery: A Systematic Review of 20 Years of Literature

Stress in surgical educational environments: a systematic review

Applying sport psychology in health professions education: A systematic review of performance mental skills training

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