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Novel Stress Test Determines When Surgeons Are Ready to Cut Loose

At the Missouri University School of Medicine, they're measuring how much residents sweat during surgery.

Published: July 7, 2017

DRY RUN Young surgeons may be deemed more ready when they perspire less during surgery.

Perspiration is the inspiration for a study being carried out at University of Missouri Health Care, where researchers are looking for a more objective way to determine when residents are ready to cut the cord and perform complex and potentially stressful surgeries without supervision.

Residents from the Missouri University School of Medicine are wearing sensors around their wrists that monitor the conductivity of their skin as they operate. The reason: The more they sweat, the more sodium they'll have on their skin. And since sodium conducts electricity, measuring conduction provides a glimpse into how much stress they're feeling.

The study has been ongoing for 2 years and will continue for at least 3 more as residents make their way through the program. Jacob Quick, MD, an acute care surgeon and the lead researcher, tells the Missourian that traditional testing and subjective evaluations by experienced physicians typically work well, but that an objective approach can provide important additional insight.

For example, standardized tests may not indicate how well residents will respond "when they're on the fly and an unexpected problem occurs," says Dr. Quick.

Before each session, residents sit quietly for 5 minutes, which allows the sensors to collect baseline stress levels. They're then monitored while performing laparoscopic cholecystectomies. Their progress will be tracked throughout their residencies and compared with what Dr. Quick calls a normal level of stress, as determined by experienced faculty members who've undergone the same monitoring.

The one big drawback: The monitors cost about $2,000 apiece, so testing has been limited to 15 residents so far and may be out of reach for some other universities.

Jim Burger

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