Psychophysical workload in the operating room: primary surgeon versus assistant

Rieger, Anja; S, Fenger; Neubert, S.; Weippert, Matthias; Kreuzfeld, Steffi; Stoll, Norbert

doi:10.1007/s00464-014-3899-6

Cited by 31 publications

(37 citation statements)

References 39 publications

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“…Comparing intraoperative workload across the surgical team, the surgeon reported the highest workload for each questionnaire subscale except mental demand, which was the highest for surgeons in training (residents). The mental and physical demands reported by surgeons were consistent with previously published ranges [ 11 , 22 , 39 , 41 , 46 , 47 ].…”

Section: Discussionsupporting

confidence: 88%

Quantifying Intraoperative Workloads Across the Surgical Team Roles: Room for Better Balance?

Lowndes

Thiels

et al. 2016

World j. surg.

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BackgroundSurgical performance, provider health, and patient safety can be compromised when workload demands exceed individual capability on the surgical team. The purpose of this study is to quantify and compare intraoperative workload among surgical team members.MethodsObservations were conducted for an entire surgical day for 33 participating surgeons and their surgical team at one medical institution. Workload (mental, physical, case complexity, distractions, and case difficulty) was measured for each surgical team member using questions from validated questionnaires. Statistical analyses were performed with a mixed effects model.ResultsA total of 192 surgical team members participated in 78 operative cases, and 344 questionnaires were collected. Procedures with high surgeon mental and physical workload included endovascular and gastric surgeries, respectively. Ratings did not differ significantly among surgeons and residents, but scrub nurses physical demand ratings were 14–22 (out of 100) points lower than the surgeons, residents, and surgical assistants. Residents reported the highest mental workload, averaging 19–24 points higher than surgical assistants, scrub nurses, and circulating nurses. Mental and physical demands exceeded 50 points 28–45 % of the time for surgeons and residents. Workload did not differ between minimally invasive and open techniques.ConclusionThe workload questionnaires are an effective tool for quantifying intraoperative workload across the surgical team to ensure mental and physical demands do not exceed thresholds where performance may decrease and injury risk increase. This tool has the potential to measure the safety of current procedures and drive design of workload interventions.

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Section: Discussionsupporting

confidence: 88%

Quantifying Intraoperative Workloads Across the Surgical Team Roles: Room for Better Balance?

Lowndes

Thiels

et al. 2016

World j. surg.

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“…Excessive training demands and related lifestyle issues, nurture this poor state of well-being [ 2 , 8 , 9 , 10 , 11 ], which may lead to burnout, a state characterized by emotional exhaustion, depersonalization and lack of personal accomplishment, ultimately associated with serious thoughts of leaving training [ 12 , 13 , 14 , 15 ]. A recent U.S. publication revealed for instance that, of the surgical residents who considered leaving the residency (44%), a majority met the criterion for burnout [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Taking control: Is job crafting related to the intention to leave surgical training?

et al. 2018

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ObjectiveThe intention to leave surgical training, hereinafter referred as proxy of “attrition,” is associated with poor well-being in the workplace. Attrition is suggested to diminish when residents possess job-crafting skills, that is, the ability to redefine their job in meaningful ways and maximize well-being at work by increasing structural and social resources and challenges and decreasing hindering demands. However, the evidence supporting this relationship is scant. This study sought to: 1) investigate to what extent residents possess job-crafting skills and compare residents’ levels of job-crafting skills across years of residency training; 2) investigate the relationship between job crafting, well-being as measured by burnout and work-engagement rates, and the intention to leave; and 3) compare the levels of job-crafting skills and well-being between residents with and without serious intentions to leave.MethodsThis cross sectional study was conducted in fifteen residency programs in Colombia. Surgical residents completed different questionnaires including the Dutch Job Crafting Scale (DJCS), MBI-Human Services Survey (MBI-HSS), Utrecht Work Engagement Scale (UWES-17) and an adapted version of the Nurse Turnover Intention Scale (NTIS). The objectives were addressed by independent analyses of variance (ANOVA), structural equation modeling techniques (SEM) and independent t-tests, respectively.ResultsA total of 202 residents participated. Residents generally scored high on their job-crafting skills to increase structural and social resources as well as challenging demands, but were less positive about their skills to reduce hindering demands. No differences across years of training were found. Job crafting correlated positively with work-engagement, which was inversely related to the intention to leave. Conversely, job crafting correlated negatively with burnout, which bore a positive relationship to the intention to leave. Residents with serious intentions to leave exhibited lower levels of most job-crafting skills and work-engagement, compared to those without such intentions.ConclusionsThis study adds evidence that attrition is a process mediated by residents’ well being at work, which can be molded by their job-crafting endeavors. Future research is needed to evaluate the effectiveness of interventions aimed at cultivating resident’s job-crafting abilities in order to reduce attrition.

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“…In situations imposing a high cognitive demand, there is a sympathetic predominance, increasing the LF/HF ratio. LF/HF ratio has been used as an objective and real‐time measure of cognitive load.…”

Section: Resultsmentioning

confidence: 99%

“…In general, studies presenting a higher MERSQI score were those that used an RCT design. The main characteristics of all included studies, as well as the MERSQI score for each are shown in Table S2 (supporting information).…”

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

156

147

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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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Psychophysical workload in the operating room: primary surgeon versus assistant

Cited by 31 publications

References 39 publications

Quantifying Intraoperative Workloads Across the Surgical Team Roles: Room for Better Balance?

Quantifying Intraoperative Workloads Across the Surgical Team Roles: Room for Better Balance?

Taking control: Is job crafting related to the intention to leave surgical training?

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

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