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Surgical Endoscopy
Erschienen in: Surgical Endoscopy 7/2016

20.10.2015

Skill acquisition and stress adaptations following laparoscopic surgery training and detraining in novice surgeons

verfasst von: Blair T. Crewther, Kunal Shetty, Delaram Jarchi, Shaun Selvadurai, Christian J. Cook, Daniel R. Leff, Ara Darzi, Guang-Zhong Yang

Erschienen in: Surgical Endoscopy | Ausgabe 7/2016

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Abstract

Background

Surgical training and practice is stressful, but adaptive changes in the stress circuitry (e.g. perceptual, physiological, hormonal, neural) could support skill development. This work examined skill acquisition and stress adaptations in novice surgeons during laparoscopic surgery (LS) training and detraining.

Methods

Twelve medical students were assessed for skill performance after 2 h (BASE), 5 h (MID) and 8 h (POST) of LS training in weeks 1–3, and then after 4 weeks of no training (RETEST). The stress outcomes included state anxiety, perceived stress and workload, heart rate (HR), heart rate variability (HRV), and salivary testosterone and cortisol concentrations. Functional near-infrared spectroscopy was used to assess cortical oxygenation change, as a marker of prefrontal cortex (PFC) activity.

Results

Skill performance improved in every session from BASE (p < 0.01), with corresponding decreases in state anxiety, stress, workload, low- and high-frequency HRV in the MID, POST and/or RETEST sessions (p < 0.05). Left and right PFC were symmetrically activated within each testing session (p < 0.01). The stress and workload measures predicted skill performance and changes over time (p < 0.05), with state anxiety, mean HR and the HRV measures also showing some predictive potential (p < 0.10).

Conclusions

A 3-week LS training programme promoted stress-related adaptations likely to directly, or indirectly, support the acquisition of new surgical skills, and many outcomes were retained after a 4-week period without further LS training. These results have implications for medical training and education (e.g. distributed training for skill development and maintenance, stress resource and management training) and highlighted possible areas for new research (e.g. longitudinal stress and skill profiling).
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Metadaten
Titel
Skill acquisition and stress adaptations following laparoscopic surgery training and detraining in novice surgeons
verfasst von
Blair T. Crewther
Kunal Shetty
Delaram Jarchi
Shaun Selvadurai
Christian J. Cook
Daniel R. Leff
Ara Darzi
Guang-Zhong Yang
Publikationsdatum
20.10.2015
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 7/2016
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4584-0

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