Simulation-Based Testing of Pager Interruptions During Laparoscopic Cholecystectomy

Area of Science:

• Surgical simulation
• Medical education
• Patient safety

Background:

• Pager interruptions are common in clinical settings.
• The impact of these interruptions on surgical performance and patient safety is not well understood.
• Effective management of external distractions is crucial for maintaining operative quality.

Purpose of the Study:

• To evaluate the effect of pager interruptions on operative time, safety, and complications during simulated laparoscopic cholecystectomy.
• To assess the ability of surgical residents to manage pager-related issues effectively.
• To identify potential areas for improving patient care quality and safety.

Main Methods:

• Twelve general surgery residents performed simulated laparoscopic cholecystectomies on a simulator.
• Each resident completed 3 procedures with pager interruptions (INT) and 3 without (NO-INT).
• Interruptions simulated patient vignettes during critical surgical steps; residents were assessed on issue management and patient care.

Main Results:

• No significant differences were observed in operative time, safety metrics, or complication rates between the INT and NO-INT groups.
• In the INT group, residents adequately addressed and managed pager issues only 25% of the time.
• Significant failures in evaluating and managing pager issues were noted.

Conclusions:

• Pager interruptions do not appear to affect operative performance or safety in simulated surgical procedures.
• Surgical residents demonstrated significant deficiencies in managing pager-related patient care issues.
• Further research is needed on strategies, such as task delegation, to mitigate risks associated with external distractions and enhance patient care quality.