Skip to main content
Erschienen in: Surgical Endoscopy 3/2018

24.08.2017

Can fatigue affect acquisition of new surgical skills? A prospective trial of pre- and post-call general surgery residents using the da Vinci surgical skills simulator

verfasst von: Weston Robison, Sonya K. Patel, Akshat Mehta, Tristan Senkowski, John Allen, Eric Shaw, Christopher K. Senkowski

Erschienen in: Surgical Endoscopy | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

Abstract

Objective

To study the effects of fatigue on general surgery residents’ performance on the da Vinci Skills Simulator (dVSS).

Methods

15 General Surgery residents from various postgraduate training years (PGY2, PGY3, PGY4, and PGY5) performed 5 simulation tasks on the dVSS as recommended by the Robotic Training Network (RTN). The General Surgery residents had no prior experience with the dVSS. Participants were assigned to either the Pre-call group or Post-call group based on call schedule. As a measure of subjective fatigue, residents were given the Epworth Sleepiness Scale (ESS) prior to their dVSS testing. The dVSS MScore™ software recorded various metrics (Objective Structured Assessment of Technical Skills, OSATS) that were used to evaluate the performance of each resident to compare the robotic simulation proficiency between the Pre-call and Post-call groups.

Results

Six general surgery residents were stratified into the Pre-call group and nine into the Post-call group. These residents were also stratified into Fatigued (10) or Nonfatigued (5) groups, as determined by their reported ESS scores. A statistically significant difference was found between the Pre-call and Post-call reported sleep hours (p = 0.036). There was no statistically significant difference between the Pre-call and Post-call groups or between the Fatigued and Nonfatigued groups in time to complete exercise, number of attempts, and high MScore™ score.

Conclusion

Despite variation in fatigue levels, there was no effect on the acquisition of robotic simulator skills.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
2.
Zurück zum Zitat Tan P, Hogle NJ, Widmann WD (2012) Limiting PGY1 residents to 16 hours of duty: review and report of a workshop. J Surg Educ 69:355–359CrossRefPubMed Tan P, Hogle NJ, Widmann WD (2012) Limiting PGY1 residents to 16 hours of duty: review and report of a workshop. J Surg Educ 69:355–359CrossRefPubMed
3.
Zurück zum Zitat Harbaugh RE, Bruce JN, Batjer HH, et al. (2016) Organized neurosurgery comments: ACGME review of resident duty hours policy. American Association of Neurological Surgeons, Rolling Meadows Harbaugh RE, Bruce JN, Batjer HH, et al. (2016) Organized neurosurgery comments: ACGME review of resident duty hours policy. American Association of Neurological Surgeons, Rolling Meadows
4.
Zurück zum Zitat Griner D, Menon RP, Kotwall CA, Clancy TV, Hope WW (2010) The eighty-hour workweek: surgical attendings’ perspectives. J Surg Educ 67:25–31CrossRefPubMed Griner D, Menon RP, Kotwall CA, Clancy TV, Hope WW (2010) The eighty-hour workweek: surgical attendings’ perspectives. J Surg Educ 67:25–31CrossRefPubMed
5.
Zurück zum Zitat Barden CB, Spect MC, McCarter MD, Daly JM, Fahey TJ III (2002) Effects of limited work hours on surgical training. Am Coll Surg V195(N4):531–533CrossRef Barden CB, Spect MC, McCarter MD, Daly JM, Fahey TJ III (2002) Effects of limited work hours on surgical training. Am Coll Surg V195(N4):531–533CrossRef
6.
Zurück zum Zitat Lehmann KS, Martus P, Little-Elk S, Maass H, Holmer C, Zurbuchen U, Bretthauer G, Buhr HJ, Ritz JP (2010) Impact of sleep deprivation on medium-term psychomotor and cognitive performance of surgeons: prospective cross-over study with a virtual surgery simulator and psychometric tests. Surgery 147(2):246–254CrossRefPubMed Lehmann KS, Martus P, Little-Elk S, Maass H, Holmer C, Zurbuchen U, Bretthauer G, Buhr HJ, Ritz JP (2010) Impact of sleep deprivation on medium-term psychomotor and cognitive performance of surgeons: prospective cross-over study with a virtual surgery simulator and psychometric tests. Surgery 147(2):246–254CrossRefPubMed
7.
Zurück zum Zitat Urchal M, Tjugum J, Martinsen E, Qiu X, Bergamaschi R (2005) The impact of sleep deprivation on product quality and procedure effectiveness in laparoscopic physical simulator: a randomized trial. Am J Surg 189:753–757CrossRef Urchal M, Tjugum J, Martinsen E, Qiu X, Bergamaschi R (2005) The impact of sleep deprivation on product quality and procedure effectiveness in laparoscopic physical simulator: a randomized trial. Am J Surg 189:753–757CrossRef
8.
Zurück zum Zitat Brown BJ, Van Susteren T, Onsager DR et al (1994) Influence of sleep deprivation on leaning among surgical house staff and medical students”. Surgery 115:604–610 Brown BJ, Van Susteren T, Onsager DR et al (1994) Influence of sleep deprivation on leaning among surgical house staff and medical students”. Surgery 115:604–610
9.
Zurück zum Zitat Waqar S, Park J, Kersey TL, Modi N, Ong C, Sleep TJ (2011) Assessment of fatigue in intraocular surgery: analysis using a virtual reality simulator. Graefes Arch Clin Exp Ophthalmol 249:77–81CrossRefPubMed Waqar S, Park J, Kersey TL, Modi N, Ong C, Sleep TJ (2011) Assessment of fatigue in intraocular surgery: analysis using a virtual reality simulator. Graefes Arch Clin Exp Ophthalmol 249:77–81CrossRefPubMed
10.
Zurück zum Zitat Tammer Y, Woldu S, Korets R, Badani K (2015) Effect of post call fatigue on surgical skills measured by a robotic simulator. J Endourol 29:479–484CrossRef Tammer Y, Woldu S, Korets R, Badani K (2015) Effect of post call fatigue on surgical skills measured by a robotic simulator. J Endourol 29:479–484CrossRef
11.
Zurück zum Zitat Eastridge BJ, Hamilton EC, O’Keefe GE, Rege RV, Rawson VJ, Jones DJ, Tesfay S, Thal ER (2003) Effect of sleep deprivation on the performance of stimulated laparoscopic surgical skill. Am J Surg 186(2):169–174CrossRefPubMed Eastridge BJ, Hamilton EC, O’Keefe GE, Rege RV, Rawson VJ, Jones DJ, Tesfay S, Thal ER (2003) Effect of sleep deprivation on the performance of stimulated laparoscopic surgical skill. Am J Surg 186(2):169–174CrossRefPubMed
12.
Zurück zum Zitat Taffinder NJ, Mcmanus IC, Gul Y, Russell RCG, Darzi A (1998) Effect of sleep deprivation on surgeons’ dexterity on laparoscopy simulator. The Lancet 352:1191CrossRef Taffinder NJ, Mcmanus IC, Gul Y, Russell RCG, Darzi A (1998) Effect of sleep deprivation on surgeons’ dexterity on laparoscopy simulator. The Lancet 352:1191CrossRef
13.
Zurück zum Zitat William S, Hafiz S, Sava JA (2013) Effects of night-float and 24-h call on resident psychomotor performance. J Surg Res 184(1):49–53CrossRef William S, Hafiz S, Sava JA (2013) Effects of night-float and 24-h call on resident psychomotor performance. J Surg Res 184(1):49–53CrossRef
14.
Zurück zum Zitat Brandenberger J, Kanav K, Feinstein AJ, Ashby A, Smith M, Ferrara FJ (2010) Effects of duty hours and time of day on surgery Brandenberger J, Kanav K, Feinstein AJ, Ashby A, Smith M, Ferrara FJ (2010) Effects of duty hours and time of day on surgery
15.
Zurück zum Zitat Olasky, Jaisa, Amine Chellali, Ganesh Sankaranarayanan, Likun Zhang, Amie Miller, Suvranu De, Daniel B. Jones, Steven D. Schwaitzberg, Benjamin E. Schneider, and Caroline G. L. Cao. “Effects of Sleep Hours and Fatigue on Performance in Laparoscopic Surgery Simulators.” Surg Endosc Surgical Endoscopy (2014): 2564-568. Print Olasky, Jaisa, Amine Chellali, Ganesh Sankaranarayanan, Likun Zhang, Amie Miller, Suvranu De, Daniel B. Jones, Steven D. Schwaitzberg, Benjamin E. Schneider, and Caroline G. L. Cao. “Effects of Sleep Hours and Fatigue on Performance in Laparoscopic Surgery Simulators.” Surg Endosc Surgical Endoscopy (2014): 2564-568. Print
16.
Zurück zum Zitat Kelly, Douglas C., Andrew C. Margules, Chandan R. Kundavaram, Hadley Narins, Leonard G. Gomella, Edouard J. Trabulsi, and Costas D. Lallas. “Face, Content, and Construct Validation of the Da Vinci Skills Simulator.” Urology (2012): 1068-072. Print Kelly, Douglas C., Andrew C. Margules, Chandan R. Kundavaram, Hadley Narins, Leonard G. Gomella, Edouard J. Trabulsi, and Costas D. Lallas. “Face, Content, and Construct Validation of the Da Vinci Skills Simulator.” Urology (2012): 1068-072. Print
17.
Zurück zum Zitat Binder J, Kramer W. Robotically-assisted laparoscopic radical prostatectomy. BJU Int 2001; 87:408 –10 Binder J, Kramer W. Robotically-assisted laparoscopic radical prostatectomy. BJU Int 2001; 87:408 –10
19.
Zurück zum Zitat Loulmet D, Carpentier A, d’Attellis N et al. Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg 1999; 118: 4 ± 10 Loulmet D, Carpentier A, d’Attellis N et al. Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg 1999; 118: 4 ± 10
20.
Zurück zum Zitat Zorn KC, Gofrit ON, Steinberg GD et al (2007) Evolution of robotic surgery in the treatment of localized prostate cancer. Curr Treat Options Oncol 8:197–210CrossRefPubMed Zorn KC, Gofrit ON, Steinberg GD et al (2007) Evolution of robotic surgery in the treatment of localized prostate cancer. Curr Treat Options Oncol 8:197–210CrossRefPubMed
21.
Zurück zum Zitat Herron DM, Marohn M (2007) A consensus document on robotic surgery. Surg Endosc 22(2):313–325CrossRefPubMed Herron DM, Marohn M (2007) A consensus document on robotic surgery. Surg Endosc 22(2):313–325CrossRefPubMed
21.
Zurück zum Zitat Hung AJ, Zehnder P, Patil MB, Cai J, Ng CK, Aron M, Gill IS, Desai MM (2011) Face, content and construct validity of a novel robotic surgery simulator. J Urol 186:1019–1026CrossRefPubMed Hung AJ, Zehnder P, Patil MB, Cai J, Ng CK, Aron M, Gill IS, Desai MM (2011) Face, content and construct validity of a novel robotic surgery simulator. J Urol 186:1019–1026CrossRefPubMed
22.
Zurück zum Zitat Finnegan KT, Meraney AM, Staff I, Shichman SJ (2012) Da Vinci skills simulator construct validation study: correlation of prior robotic experience with overall score and time score simulator performance. Urology 80(2):330–336CrossRefPubMed Finnegan KT, Meraney AM, Staff I, Shichman SJ (2012) Da Vinci skills simulator construct validation study: correlation of prior robotic experience with overall score and time score simulator performance. Urology 80(2):330–336CrossRefPubMed
23.
Zurück zum Zitat Da Vinci Surgery Customer Portal.” General Surgery. N.p., n.d. Web. 19 Jan 2016 Da Vinci Surgery Customer Portal.” General Surgery. N.p., n.d. Web. 19 Jan 2016
24.
Zurück zum Zitat Curriculum. Robotics Training Network. N.p., n.d. Web. 19 July 2016 Curriculum. Robotics Training Network. N.p., n.d. Web. 19 July 2016
25.
Zurück zum Zitat Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRefPubMed Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRefPubMed
26.
Zurück zum Zitat Johns MW (1992) Reliability and factor analysis of the Epworth sleepiness scale. Sleep 15:376–381CrossRefPubMed Johns MW (1992) Reliability and factor analysis of the Epworth sleepiness scale. Sleep 15:376–381CrossRefPubMed
27.
Zurück zum Zitat Bilirmoria KY, Chung JW, Hedges LV, Dahlke AR, Love R, Cohen ME, Hoyt DB, Yang AD, Tarpley JL, Mellinger JD, Mahvi DM, Kelz RR, Ko CY, Odell DD, Stulber JJ, Lewis FR. National cluster-randomized trail of duty-hours flexibility in surgical training. NEJM 1–15 Bilirmoria KY, Chung JW, Hedges LV, Dahlke AR, Love R, Cohen ME, Hoyt DB, Yang AD, Tarpley JL, Mellinger JD, Mahvi DM, Kelz RR, Ko CY, Odell DD, Stulber JJ, Lewis FR. National cluster-randomized trail of duty-hours flexibility in surgical training. NEJM 1–15
28.
Zurück zum Zitat Damadi A, Davis AT, Saxe A et al (2007) ACGME duty-hour restrictions decrease resident operative volume: a 5-year comparison at an ACGME-accredited university general surgery residency. J Surg Educ 64(5):256–259CrossRefPubMed Damadi A, Davis AT, Saxe A et al (2007) ACGME duty-hour restrictions decrease resident operative volume: a 5-year comparison at an ACGME-accredited university general surgery residency. J Surg Educ 64(5):256–259CrossRefPubMed
Metadaten
Titel
Can fatigue affect acquisition of new surgical skills? A prospective trial of pre- and post-call general surgery residents using the da Vinci surgical skills simulator
verfasst von
Weston Robison
Sonya K. Patel
Akshat Mehta
Tristan Senkowski
John Allen
Eric Shaw
Christopher K. Senkowski
Publikationsdatum
24.08.2017
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 3/2018
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5820-6

Weitere Artikel der Ausgabe 3/2018

Surgical Endoscopy 3/2018 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.