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01.12.2018 | Research | Ausgabe 1/2018 Open Access

Patient Safety in Surgery 1/2018

Self-assessment of surgical ward crisis management using video replay augmented with stress biofeedback

Patient Safety in Surgery > Ausgabe 1/2018
Pasha Normahani, Nita Makwana, Wilhelm von Rosenberg, Sadie Syed, Danilo P. Mandic, Valentin Goverdovsky, Nigel J. Standfield, Usman Jaffer
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s13037-018-0153-5) contains supplementary material, which is available to authorized users.



We aimed to explore the feasibility and attitudes towards using video replay augmented with real time stress quantification for the self-assessment of clinical skills during simulated surgical ward crisis management.


Twenty two clinicians participated in 3 different simulated ward based scenarios of deteriorating post-operative patients. Continuous ECG recordings were made for all participants to monitor stress levels using heart rate variability (HRV) indices. Video recordings of simulated scenarios augmented with real time stress biofeedback were replayed to participants. They were then asked to self-assess their performance using an objective assessment tool. Participants attitudes were explored using a post study questionnaire.


Using HRV stress indices, we demonstrated higher stress levels in novice participants. Self-assessment scores were significantly higher in more experienced participants. Overall, participants felt that video replay and augmented stress biofeedback were useful in self-assessment.


Self-assessment using an objective self-assessment tool alongside video replay augmented with stress biofeedback is feasible in a simulated setting and well liked by participants.
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