Determining the Effect of External Stressors on Laparoscopic Skills and Performance Between Obstetrics and Gynecology Residents.

MedStar author(s):
Citation: Journal of Surgical Education. 74(5):862-866, 2017 Sep - Oct.PMID: 28552418Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and GynecologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Clinical Competence | *Gynecologic Surgical Procedures/ed [Education] | *Laparoscopy/ed [Education] | *Laparoscopy/px [Psychology] | *Obstetric Surgical Procedures/es [Ethics] | Adult | Cohort Studies | Education, Medical, Graduate/mt [Methods] | Female | Humans | Internship and Residency/mt [Methods] | Male | Prospective Studies | Psychomotor Performance | Simulation Training | Stress, PsychologicalYear: 2017ISSN:
  • 1878-7452
Name of journal: Journal of surgical educationAbstract: CONCLUSION: Our work confirmed that while under stress residents were more efficient, this translated into their ability to complete tasks faster in all the tested skills. Efficiency, however, came at the expense of accuracy.Copyright � 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.DESIGN CLASSIFICATION: Prospective cohort.DESIGN: Observational prospective cohort study.INTERVENTION: We assessed 4 basic laparoscopic skills at 2 sessions. The first session was the baseline; 6 months later the same skills were assessed under audiovisual stressors. We compared the effect of stress on accuracy and efficiency between the 2 sessions.MEASUREMENTS AND MAIN RESULTS: A linear model was used to analyze time. Under stress, residents were more efficient in 3 of the 4 modules. Ring transfer (hand-eye coordination and bimanual dexterity), p = 0.0304. Ring of fire (bimanual dexterity and measure of depth perception), p = 0.0024 and dissection glove (respect of delicate tissue planes), p = 0.0002. Poisson regression was used to analyze the total number of penalties. Residents were more likely to acquire penalties under stress. Ring transfer, p = 0.0184 and cobra (hand-to-hand coordination), p = 0.0487 yielded a statistically significant increase in penalties in the presence of stressors. Dissection glove p = 0.0605 yielded a nonsignificant increase in penalties.PARTICIPANTS (PATIENTS): Thirty-one obstetrics and gynecology residents, postgraduate years 1 to 4.SETTING: Urban teaching university hospital.STUDY OBJECTIVE: To evaluate the effect of stress on laparoscopic skills between obstetrics and gynecology residents.All authors: Abi Khalil ED, Krapf J, Kumar D, Marfori C, Moawad GN, Robinson J, Tyan PFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-06-14
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Journal Article MedStar Authors Catalog Article 28552418 Available 28552418

CONCLUSION: Our work confirmed that while under stress residents were more efficient, this translated into their ability to complete tasks faster in all the tested skills. Efficiency, however, came at the expense of accuracy.

Copyright � 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

DESIGN CLASSIFICATION: Prospective cohort.

DESIGN: Observational prospective cohort study.

INTERVENTION: We assessed 4 basic laparoscopic skills at 2 sessions. The first session was the baseline; 6 months later the same skills were assessed under audiovisual stressors. We compared the effect of stress on accuracy and efficiency between the 2 sessions.

MEASUREMENTS AND MAIN RESULTS: A linear model was used to analyze time. Under stress, residents were more efficient in 3 of the 4 modules. Ring transfer (hand-eye coordination and bimanual dexterity), p = 0.0304. Ring of fire (bimanual dexterity and measure of depth perception), p = 0.0024 and dissection glove (respect of delicate tissue planes), p = 0.0002. Poisson regression was used to analyze the total number of penalties. Residents were more likely to acquire penalties under stress. Ring transfer, p = 0.0184 and cobra (hand-to-hand coordination), p = 0.0487 yielded a statistically significant increase in penalties in the presence of stressors. Dissection glove p = 0.0605 yielded a nonsignificant increase in penalties.

PARTICIPANTS (PATIENTS): Thirty-one obstetrics and gynecology residents, postgraduate years 1 to 4.

SETTING: Urban teaching university hospital.

STUDY OBJECTIVE: To evaluate the effect of stress on laparoscopic skills between obstetrics and gynecology residents.

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