Abstract
Background
Overwhelming stress in the operating room can lead to decay in operative performance,
particularly for residents who lack experience. Mental skills training can minimize
deterioration in performance during challenging situations. We hypothesized that residents
trained on mental skills would outperform controls under increased stress conditions
in the simulated operating room.
Methods
Residents from Indiana University enrolled voluntarily in this institutional review
board–approved study. Residents were stratified according to baseline characteristics
and randomized into a mental skills and control group. Both groups trained to proficiency
in laparoscopic suturing, but only the mental skills group received mental skills
training. After training, technical skill transfer was assessed under regular and
stressful conditions on a porcine model. Performance was assessed using an objective
suturing score. The Test of Performance Strategies was used to assess the use of mental
skills. Data were combined and compared with data that had been collected at Carolinas
Healthcare System because residents underwent the same protocol.
Results
A total of 38 residents completed all study elements. There were no differences in
the effects observed between sites. We observed no group differences at baseline.
The groups achieved similar technical performance at baseline, posttest, and transfer
test under low-stress conditions, but the mental skills group outperformed the control
group during the transfer test under high-stress conditions.
Conclusion
Our comprehensive mental skills curriculum implemented with surgery residents at two
institutions was effective at minimizing the deterioration of resident technical performance
under stressful conditions compared with controls. These results provide further evidence
for the effectiveness of mental skills training to optimize surgery trainees’ technical
performance during challenging clinical situations.
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Article info
Publication history
Published online: March 25, 2019
Accepted:
January 17,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
