Veille documentaire MTPH

Médecine du travail du personnel hospitalier

Comparing technical dexterity of sleep-deprived versus intoxicated surgeons

Auteur       Fariba Mohtashami
Auteur       Allison Thiele
Auteur       Erwin Karreman
Auteur       John Thiel
Volume       18
Numéro       4
Publication       JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
ISSN       1938-3797
Date       2014 Oct-Dec
Résumé       BACKGROUND: The evidence on the effect of sleep deprivation on the cognitive and motor skills of physicians in training is sparse and conflicting, and the evidence is nonexistent on surgeons in practice. Work-hour limitations based on these data have contributed to challenges in the quality of surgical education under the apprentice model, and as a result there is an increasing focus on competency-based education. Whereas the effects of alcohol intoxication on psychometric performance are well studied in many professions, the effects on performance in surgery are not well documented. To study the effects of sleep deprivation on the surgical performance of surgeons, we compared simulated the laparoscopic skills of staff gynecologists « under 2 conditions »: sleep deprivation and ethanol intoxication. We hypothesized that the performance of unconsciously competent surgeons does not deteriorate postcall as it does under the influence of alcohol. METHODS: Nine experienced staff gynecologists performed 3 laparoscopic tasks in increasing order of difficulty (cup drop, rope passing, pegboard exchange) on a box trainer while sleep deprived (0.08 mg/mL blood alcohol concentration). Three expert laparoscopic surgeons scored the anonymous clips online using Global Objective Assessment of Laparoscopic Skills criteria: depth perception, bimanual dexterity, and efficiency. Data were analyzed by a mixed-design analysis of variance. RESULTS: There were large differences in mean performance between the tasks. With increasing task difficulty, mean scores became significantly (P < .05) poorer. For the easy tasks, the scores for sleep-deprived and intoxicated participants were similar for all variables except time. Surprisingly, participants took less time to complete the easy tasks when intoxicated. However, the most difficult task took less time but was performed significantly worse compared with being sleep deprived. Notably, the evaluators did not recognize a lack of competence for the easier tasks when intoxicated; incompetence surfaced only in the most difficult task. CONCLUSIONS: Being intoxicated hinders the performance of more difficult simulated laparoscopic tasks than being sleep deprived, yet surgeons were faster and performed better on simple tasks when intoxicated.

Export bibliographique

Chercher cette référence sur : Google Scholar, Worldcat


Laisser une réponse

Vous devez etre connectez Pour poster un commentaire