Impact of Fatigue on Neurophysiologic Measures of Surgical Residents
Identifieur interne : 003337 ( Main/Exploration ); précédent : 003336; suivant : 003338Impact of Fatigue on Neurophysiologic Measures of Surgical Residents
Auteurs : Kanav Kahol [États-Unis] ; Marshall Smith [États-Unis] ; Jared Brandenberger [États-Unis] ; Aaron Ashby [États-Unis] ; John J. Ferrara [États-Unis]Source :
- Journal of the American College of Surgeons [ 1072-7515 ] ; 2011.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie, Analyse quantitative, Médecine.
English descriptors
- KwdEn :
Abstract
BACKGROUND: To gain additional insight into the impact of fatigue on surgery resident proficiency, we set out to quantify its impact on behavioral and neurophysiologic measures. STUDY DESIGN: Simulations were first created using a visio-haptic joystick attached to a surgical instrument (tool) that allows realistic interactions. Before baseline (pre-call) and after call, 7 PGY1 surgery residents performed simulation tasks that required varying levels of psychomotor and cognitive skill. Residents completed 3 sessions per week for 4 weeks. Surgical proficiency was established using 5 metrics: hand movement smoothness; instrument movement smoothness; time to task completion; gesture level proficiency and cognitive errors. Data (percent change from baseline, pre-call) were analyzed using repeated measures ANOVA. While performing these tasks, the residents also wore an EEG cap (B-Alert; Advanced Brain Monitoring), the data from which provided second to second insight into the effects of workload, distraction, and attention on task performance. Mean (±SD) pre-call and post-call values for each were analyzed using repeated measures ANOVA. RESULTS: Residents experienced significant (p < 0.014) post-call erosions in surgical proficiency, punctuated by dramatic increases in cognitive errors. EEG-based attention scores showed a significant (p < 0.014) concomitant decrement of 40%; distraction/drowsiness scores increased by 91%; and workload score increased by 51%. CONCLUSIONS: Fatigue adversely affects PGY1 resident surgical proficiency and neurophysiologic performance.
Affiliations:
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Ferrara</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Human Machine Symbiosis Laboratory, School of Biological and Health Systems Engineering, Arizona State University</s1><s3>USA</s3><sZ>1 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Human Machine Symbiosis Laboratory, School of Biological and Health Systems Engineering, Arizona State University</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Journal of the American College of Surgeons</title><title level="j" type="abbreviated">J. Am. Coll. Surg.</title><idno type="ISSN">1072-7515</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of the American College of Surgeons</title><title level="j" type="abbreviated">J. Am. Coll. Surg.</title><idno type="ISSN">1072-7515</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Fatigue</term><term>Medicine</term><term>Quantitative analysis</term><term>Resident (student)</term><term>Surgery</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Chirurgie</term><term>Fatigue</term><term>Analyse quantitative</term><term>Interne (étudiant)</term><term>Médecine</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term><term>Analyse quantitative</term><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND: To gain additional insight into the impact of fatigue on surgery resident proficiency, we set out to quantify its impact on behavioral and neurophysiologic measures. STUDY DESIGN: Simulations were first created using a visio-haptic joystick attached to a surgical instrument (tool) that allows realistic interactions. Before baseline (pre-call) and after call, 7 PGY1 surgery residents performed simulation tasks that required varying levels of psychomotor and cognitive skill. Residents completed 3 sessions per week for 4 weeks. Surgical proficiency was established using 5 metrics: hand movement smoothness; instrument movement smoothness; time to task completion; gesture level proficiency and cognitive errors. Data (percent change from baseline, pre-call) were analyzed using repeated measures ANOVA. While performing these tasks, the residents also wore an EEG cap (B-Alert; Advanced Brain Monitoring), the data from which provided second to second insight into the effects of workload, distraction, and attention on task performance. Mean (±SD) pre-call and post-call values for each were analyzed using repeated measures ANOVA. RESULTS: Residents experienced significant (p < 0.014) post-call erosions in surgical proficiency, punctuated by dramatic increases in cognitive errors. EEG-based attention scores showed a significant (p < 0.014) concomitant decrement of 40%; distraction/drowsiness scores increased by 91%; and workload score increased by 51%. CONCLUSIONS: Fatigue adversely affects PGY1 resident surgical proficiency and neurophysiologic performance.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Arizona</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Kahol, Kanav" sort="Kahol, Kanav" uniqKey="Kahol K" first="Kanav" last="Kahol">Kanav Kahol</name></noRegion><name sortKey="Ashby, Aaron" sort="Ashby, Aaron" uniqKey="Ashby A" first="Aaron" last="Ashby">Aaron Ashby</name><name sortKey="Brandenberger, Jared" sort="Brandenberger, Jared" uniqKey="Brandenberger J" first="Jared" last="Brandenberger">Jared Brandenberger</name><name sortKey="Ferrara, John J" sort="Ferrara, John J" uniqKey="Ferrara J" first="John J." last="Ferrara">John J. Ferrara</name><name sortKey="Kahol, Kanav" sort="Kahol, Kanav" uniqKey="Kahol K" first="Kanav" last="Kahol">Kanav Kahol</name><name sortKey="Kahol, Kanav" sort="Kahol, Kanav" uniqKey="Kahol K" first="Kanav" last="Kahol">Kanav Kahol</name><name sortKey="Smith, Marshall" sort="Smith, Marshall" uniqKey="Smith M" first="Marshall" last="Smith">Marshall Smith</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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