Younger, less-experienced surgeons are more prone to distraction in the OR - and to make surgical errors as a result, according to researchers at Oregon State University and the Oregon Health and Science University.
The analysis centered on a simulated laparoscopic cholecystectomy in which surgeons could be distracted by noises, questions, conversation or other commotion in the operating room. Eight of 18 (44%) second-, third- and research-year surgical residents made serious errors, particularly when they were being tested in the afternoon. By comparison, only 1 surgeon made a mistake when there were no distractions.
While the young surgeons, aged 27 to 35, were trying to perform the lap chole, a cell phone would ring, followed later by a metal tray clanging to the floor. Questions would be posed about problems developing with a previous surgical patient - a necessary conversation - and someone off to the side would begin talking about politics, a not-so-necessary but fairly realistic distraction. Interrupting questions caused the most major errors (such as damage to internal organs, ducts and arteries), followed by sidebar conversations. Interestingly, participants facing disruptions did much worse in the afternoons, although conventional fatigue didn't appear to be an issue.
This study, published in Archives of Surgery, sought insights on "human factors engineering," a field seeking to identify why mistakes happen, what approaches or systems can contribute to the errors, and ways to improve performance.
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