Evaluation of stress patterns during simulated laparoscopy in residency

Area of Science:

• Medical Education
• Surgical Simulation
• Physiological Stress Response

Background:

• Laparoscopy simulation is crucial for developing surgical skills.
• The relationship between stress and simulation experience needs further exploration.
• Understanding stress in surgical trainees is key for effective learning.

Purpose of the Study:

• Evaluate stress levels in surgery interns (PGY-1) and residents (PGY-2) before and during laparoscopy simulation.
• Assess simulated laparoscopy performance in both groups.
• Investigate correlations between stress pathways and factors influencing stress-performance relationships.

Main Methods:

• Included 7 PGY-1 and 6 PGY-2 participants.
• Measured salivary cortisol (SC), heart rate (HR), and heart rate variability (pNN50) at multiple time points.
• Assessed perceived stress and used the MISTELS scale for performance evaluation.

Main Results:

• Simulation induced stress in the study population.
• PGY-1 showed increased SC and HR with decreased pNN50 during the procedure.
• PGY-2 exhibited increased HR and decreased pNN50 before the procedure; PGY-2 had higher performance scores.

Conclusions:

• Identified two distinct stress patterns based on experience level.
• PGY-1 stress increased during the procedure, while PGY-2 stress occurred prior.
• Learner experience significantly influences the impact of simulation on stress parameters.