The Effect of External Distractions on Simulated Laparoscopic Performance

Area of Science:

• Medical Education
• Surgical Simulation
• Human Factors Engineering

Background:

• Surgeons face unavoidable distractions during operations, potentially increasing stress.
• Elevated stress can impair cognitive and motor skills, negatively affecting surgical performance.
• Understanding the impact of distractions is crucial for improving surgical training and patient safety.

Purpose of the Study:

• To assess the impact of operating room distractions on surgeon stress levels.
• To evaluate the effect of distractions on surgeon performance during simulated laparoscopic tasks.
• To explore the potential of surgical simulation for stress inoculation.

Main Methods:

• Twelve surgical trainees performed a simulated laparoscopic peg-thread transfer task.
• Participants were divided into a distracted group and a neutral environment control group.
• Stress was measured via heart rate and NASA Task Load Index; performance by instrument tracking and task completion time.

Main Results:

• The distracted group reported significantly higher effort, frustration, and physical demand (NASA Task Load Index, P = .001, .031, .044).
• The neutral group improved task completion time compared to baseline (P = .049), while the distracted group did not.
• Distracted surgeons exhibited increased hand discordance, indicating reduced ambidexterity.

Conclusions:

• Distractions in the surgical environment lead to increased subjective stress and impair specific aspects of performance.
• Surgical simulation can be a valuable tool for 'stress inoculation,' training surgeons to maintain performance under distracting conditions.
• Further research into optimizing simulation-based training can enhance surgeon resilience and patient outcomes.