Do absorption and realistic distraction influence performance of component task surgical procedure?

Department of Information Systems and Management, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands.
Surgical Endoscopy (Impact Factor: 3.26). 09/2009; 24(4):902-7. DOI: 10.1007/s00464-009-0689-7
Source: PubMed


Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance.
Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting conditions (exposure to music, conversation, and nonoptimal handling of the laparoscope) versus nondistracting conditions (control condition) as part of a 2 x 2 within-subject experimental design.
Under distracting conditions, the medical interns showed a significant decline in task performance (overall task score, task errors, and operating time) and significantly increased levels of irritation toward both the assistant handling the laparoscope in a nonoptimal way and the sources of social distraction. Furthermore, individual differences in cognitive style (i.e., cognitive absorption and need for cognition) significantly influenced the levels of irritation experienced by the medical interns.
The results suggest careful evaluation of the social and technological sources of distraction in the operation room to reduce irritation for the surgeon and provision of proper preclinical laparoscope navigation training to increase security for the patient.

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Available from: Jack J Jakimowicz, Jul 27, 2015
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    • "How should the findings be used to influence policy/ practice/research/education? • Decisions around whether music is played and around the choice of music and its volume should be made by operating teams, not individual staff, taking into account the potential negative effects it can have on communication • Frank discussions between clinicians, managers, patients and governing bodies should be encouraged for recommendations and guidance to be developed. et al. 2010), four laboratory-based experiment and survey (Hawksworth et al. 1998, Moorthy et al. 2004, Sanderson et al. 2005, Pluyter et al. 2010) and one randomised controlled trial (Miskovic et al. 2008). A variety of theatre staff healthcare professionals were observed across studies, with surgeons dominating. "
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    ABSTRACT: To observe the extent and the detail with which playing music can impact on communication in the operating theatre. According to the cited sources, music is played in 53-72% of surgical operations performed. Noise levels in the operating theatre already exceed World Health Organisation recommendations. There is currently a divide in opinions on the playing of music in operating theatres, with few studies conducted and no policies or guidance provided. An ethnographic observational study of teamwork in operating theatres through video recordings. Quantitative and qualitative data analysis approaches were used. This study was conducted between 2012-2013 in the UK. Video recordings of 20 operations over six months in two operating theatres were captured. The recordings were divided into music and non-music playing cases. Each case was logged using a request/response sequence identified through interactional analysis. Statistical analysis, using a χ(2) , explored the difference between the proportion of request repetitions and whether music was playing or not. Further interactional analysis was conducted for each request repetition. Request/response observations (N = 5203) were documented. A chi-square test revealed that repeated requests were five times more likely to occur in cases that played music than those that did not. A repeated request can add 4-68 seconds each to operation time and increased tensions due to frustration at ineffective communication. Music played in the operating theatre can interfere with team communication, yet is seldom recognized as a potential safety hazard. Decisions around whether music is played and around the choice of music and its volume, are determined largely by surgeons. Frank discussions between clinicians, managers, patients and governing bodies should be encouraged for recommendations and guidance to be developed. © 2015 John Wiley & Sons Ltd.
    Journal of Advanced Nursing 08/2015; DOI:10.1111/jan.12744 · 1.74 Impact Factor
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    • "Tramo et al., 2003) and the neuroanatomy of music performance (Parsons, 2003). And breadth of study has ranged from the perception of folk songs inside the womb (Lemos et al., 2011), to the performance of opera on concert platforms (Kenny et al., 2004), and the use of pop music in operating theatres (Pluyter et al., 2010). "
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    • "However, the effect of environmental events should not be underestimated. Especially the performance of inexperienced surgeons or residents could be influenced by distraction, as shown in a previous study [18]. "
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    ABSTRACT: This study aimed to identify the frequency of events in the different patient safety risk domains during minimally invasive surgery (MIS) and conventional surgery (CS). A convenience sample of gynecologic MIS and CS was observed. Events were observed and categorized into one of the predefined patient safety risk domains. A total of 53 procedures were observed: 26 CS and 27 MIS procedures. The general characteristics were comparable between the two groups. A large number of environmental events were observed, averaging one every 2.5 min. Technical events and events of an organizational nature occurred more often in MIS (P < 0.01) than in CS (P < 0.01). The relative risk for the occurrence of one or more technical events in MIS compared with CS was 1.7, and the risk for two or more technical events was 4.1. A time out according to protocol showed no relationship to the occurrence of the different types of patient safety-related events. The technological complexity inherent in MIS makes this type of surgery more prone to technology-related problems than CS, even in a specially designed minimally invasive surgical suite. A regular time-out procedure developed for CS lacks the attention necessary for the complex technology used in MIS and therefore is insufficient for MIS procedures briefing. Incorporating a specially designed technology checklist in a regular briefing protocol could be a solution to decrease the number of events in MIS.
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