Intraocular pressure increases after complex simulated surgical procedures in residents: an experimental study

Area of Science:

• Medical Simulation
• Surgical Training
• Physiological Monitoring

Background:

• Surgeon overload is a significant factor contributing to medical errors and patient safety concerns.
• Current methods for monitoring surgeon workload have limitations, necessitating the development of new, objective indices.
• Intraocular pressure (IOP) has previously shown promise as a sensitive, unbiased physiological indicator of task complexity and duration in non-healthcare settings.

Purpose of the Study:

• To investigate the effect of demanding simulated surgical procedures on the intraocular pressure (IOP) of surgical and medical residents.
• To determine if IOP can serve as a sensitive and objective measure of task load in a healthcare context.

Main Methods:

• Thirty-four residents and healthcare professionals participated, divided into an experimental group (N=17) and a matched control group (N=17).
• The experimental group performed two simulated bronchoscopy procedures of varying complexity, while the control group performed matched physical movements.
• Intraocular pressure (IOP) was measured pre- and post-procedure, alongside assessments of surgical performance and perceived task complexity.

Main Results:

• Intraocular pressure (IOP) significantly increased in the experimental group only after the more complex simulated surgical procedure.
• Residents demonstrated poorer performance and reported higher perceived task complexity during the more demanding procedure.
• These findings correlate IOP changes with increased task load and difficulty.

Conclusions:

• Intraocular pressure (IOP) is sensitive to task load in surgical residents, indicating its potential as a novel index for assessing workload in healthcare.
• The study provides evidence for using IOP as an easily and rapidly measurable tool to assess task (over)load.
• Arousal-based mechanisms are proposed to explain the observed variations in IOP related to task complexity.