Optimizing performance through stress training - An educational strategy for surgical residents

Stress management programs improve efficacy in aviation, military, and professional sports; however, similar educational strategies have not been adopted in surgical training. We have evaluated the effectiveness of a stress management program for surgical residents.

From 2011 to 2016, 137 surgical residents participated in a prospective, blinded study. The intervention group (n = 65) underwent training in self-awareness, focus, relaxation, positive self-talk, visualization, and team building. All participants subsequently completed a high-stress trauma simulation, requiring diagnosis and management of a life-threatening problem. Study endpoints included measures of procedural efficiency, and physiologic and subjective measurements of anxiety.

Residents with stress training came to an accurate diagnosis 21% faster than controls (mean diagnosis time: 2.2 vs. 2.8 min; p = 0.04), and performed with greater technical accuracy (mean OSAT scores: 9.4 vs. 8.9; p = 0.03). Both cohorts exhibited similar physiologic and subjective anxiety metrics after simulation.

Stress management education may enhance technical performance in surgical trainees during simulation. This underscores the need for early, comprehensive stress training in surgical residency.