Background
There is gathering interest in determining the typical sources of stress for an operating
surgeon and the effect that stressors might have on operative performance. Much of
the research in this field, however, has failed to measure stress levels and performance
concurrently or has not acknowledged the differential impact of potential stressors.
Our aim was to examine empirically the influence of different sources of stress on
trained laparoscopic performance.
Methods
A total of 30 medical students were trained to proficiency on the validated Fundamentals
of Laparoscopic Surgery peg transfer task, and then were tested under 4 counterbalanced
test conditions: control, evaluation threat, multitasking, and time pressure. Performance
was assessed via completion time and a process measure reflecting the efficiency of
movement (ie, path length). Stress levels in each test condition were measured using
a multidimensional approach that included the State-Trait Anxiety Inventory (STAI)
and the subject’s heart rate while performing a task.
Results
The time pressure condition caused the only significant increase in stress levels
but did not influence completion time or the path length of movement. Only the multitasking
condition significantly increased completion time and path length, despite there being
no significant increase in stress levels. Overall, the STAI and heart rate measures
were not correlated strongly.
Conclusion
Recommended measures of stress levels do not necessarily reflect the demands of an
operative task, highlighting the need to understand better the mechanisms that influence
performance in surgery. This understanding will help inform the development of training
programs that encourage the complete transfer of skills from simulators to the operating
room.
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Article info
Publication history
Published online: February 11, 2011
Accepted:
December 7,
2010
Footnotes
Supported by a bilateral research grant from the UK Economic and Social Research Council and the Research Grants Council of Hong Kong, China (RES-000-22-3016 to M.R.W. and R.S.W.M.) and a grant from the University of Hong Kong Seed Funding Programme for Basic Research (to J.M.P).
Identification
Copyright
© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
