Jack Barney award: The effect of fatigue on cognitive and psychomotor skills of trauma residents and attending surgeons

Gerdes, Jodi; Kahol, Kanav; Smith, Marshall; Leyba, Mario J.; Ferrara, John J.

doi:10.1016/j.amjsurg.2008.07.030

« Previous Next »The American Journal of Surgery
Volume 196, Issue 6 , Pages 813-820, December 2008

Jack Barney award: The effect of fatigue on cognitive and psychomotor skills of trauma residents and attending surgeons

Jodi Gerdes, M.D.
- Simulation and Education Training Center, Banner, Good Samaritan Medical Center, 925 E McDowell Road, Second Floor, Phoenix, AZ 85006, USA
Kanav Kahol, Ph.D.
- Simulation and Education Training Center, Banner, Good Samaritan Medical Center, 925 E McDowell Road, Second Floor, Phoenix, AZ 85006, USA
- Department of Biomedical Informatics, Center for Cognitive Ubiquitous Computing, School of Computing and Informatics, Arizona State University, Tempe, AZ, USA
Marshall Smith, M.D.
- Simulation and Education Training Center, Banner, Good Samaritan Medical Center, 925 E McDowell Road, Second Floor, Phoenix, AZ 85006, USA
Mario J. Leyba, M.D.
- Simulation and Education Training Center, Banner, Good Samaritan Medical Center, 925 E McDowell Road, Second Floor, Phoenix, AZ 85006, USA
John J. Ferrara, M.D.
- Simulation and Education Training Center, Banner, Good Samaritan Medical Center, 925 E McDowell Road, Second Floor, Phoenix, AZ 85006, USA
- Corresponding author. Tel.: +1-602-239-2282; fax: +1-602-495-9112

Received 3 May 2008; received in revised form 3 July 2008

Abstract

Background

Fatigue and sleep deprivation and their effects on surgical proficiency have been actively researched areas. Past studies that have focused solely on residents have provided an important insight into how fatigue affects residents' ability to perform. This study aims to quantify the effect of fatigue on attending surgeons.

Methods

To quantify the effect of fatigue on psychomotor and cognitive skills of surgical residents and attending surgeons, visiohaptic simulations were created to mimic realistic interactions.

Results

Both groups showed a significant decrement in proficiency measures postcall. When tasks were separated based on psychomotor versus cognitive-dominated skills, attending surgeons made 25% fewer (P < .05) cognitive errors than residents postcall. Psychomotor skills were equally affected in both groups.

Conclusions

Call-associated fatigue is associated with increased error rates in the cognitive skill domain, although less so in attending surgeons compared with their resident counterparts.

Keywords: Fatigue, Cognitive skills, Psychomotor skills, Experience, Surgical residents, Attending surgeons