Emotional visual stimuli and simulated laparoscopic surgical performance: A pilot cohort study

https://doi.org/10.1016/j.surge.2023.06.004Get rights and content
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Highlights

  • Exposure to stress prior to or during surgery can negatively impact performance.

  • The impact of emotive visual stressors on surgical performance are poorly understood.

  • This model system assesses the impact of visual stress on surgical performance.

  • Emotional stimuli alter learning curves in novice students learning new tasks.

  • Further study may allow for the targeted development of coping mechanisms.

Abstract

Background

Exposure to stress prior to or during surgery can negatively impact performance. Management of stress is an essential non-technical skill required for safe practice. The effects of exposure to emotional visual stressors on surgical performance are poorly understood. This study aims to develop a model to investigate effects of emotive visual stimuli on simulated laparoscopic performance.

Methods and materials

A single-centre cohort study. Thirty novice, simulator-naïve medical students were randomly allocated to view either positive, negative, or neutral emotional images (sourced from validated image registry). Participants focused for 5 s on the image before completing a peg-threading laparoscopic task. Time, instrument distance, speed, acceleration, motion smoothness, and ambidexterity were recorded automatically with instrument tracking software. 8 task cycles were completed; 3 control practices followed by 5 with the stimuli, according to group allocation.

Results

The final performance metrics of students (time, distance, speed, and motion smoothness) were not significantly different when comparing positive and neutral stimuli groups to those shown negative stimuli. However, changes were seen in the rate of performance improvements (positive: p = 0.711, p = 0.837, p = 0.297, and p = 0.393) (neutral: p = 0.285, p = 0.918, p = 0.835, and p = 0.396). Participation improved performance metrics overall (p=<0.001, p=<0.001, p = 0.088, p = 0.025, p=<0.001).

Conclusion

Model systems may be valuable for investigating the impact of stress on surgeon performance. The effect of emotive visual stimuli on surgical performance is complex. This model may aid the further exploration of these relationships and ultimately can provide an environment in which surgeons can develop strategies to mitigate the adverse effect of stressors.

Keywords

Stress
Simulation
Surgical performance
Laparoscopy

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