Stress responses in surgical trainees during simulation-based training courses in laparoscopy.

Area of Science:

• Medical Education
• Surgical Training
• Human Physiology

Background:

• Laparoscopic simulation training is crucial for surgical education.
• Mastering laparoscopic skills is challenging and induces stress in trainees.
• Limited data exists on stress responses during simulation training and the impact of prior experience.

Purpose of the Study:

• To investigate physiological, endocrine, and self-reported stress responses in surgical trainees during simulation-based laparoscopic skills training.
• To explore the correlation between previous laparoscopic experience and stress responses.

Main Methods:

• Prospective observational study of 24 surgical trainees over a three-day basic laparoscopic skills course.
• Trainees used D-box, P.O.P. trainer, and LAPMentor™ simulators.
• Stress was measured using heart rate variability (HRV), saliva cortisol, and the State Trait Anxiety Inventory-6 (STAI-6).

Main Results:

• Stress measures (HRV, STAI-6) were significantly higher during simulation training compared to rest across all simulators.
• A significant increase in saliva cortisol was observed during D-box simulation.
• No significant differences in stress responses were found between the three simulators.
• Surgical experience showed moderate correlations with physiological and endocrine stress measures and self-reported stress.

Conclusions:

• Simulation-based laparoscopic training significantly increases trainee stress compared to resting conditions.
• No single simulator demonstrated a higher stress response than others.
• The D-box simulator, potentially due to time pressure, induced higher cortisol levels.
• Increased surgical experience is linked to higher physiological stress but lower perceived stress during simulation training.