Start and end dates
August 2007 - September 2010
Team
- Sonal Arora (Pricipal Investigator and key contact)
- Nick Sevdalis
- Roger Kneebone
- Ara Darzi
- Raj Aggarwal
Project summary
Background
Safe surgical practice requires a combination of technical and non-technical skills. Acute stress can impair both sets of skills, thereby compromising both surgical performance and patient safety in the operating theatre.
This project uses a systematic and scientific analysis to investigate stress in surgeons with the global aim of developing a practical, evidence-based intervention to reduce stress and its deleterious consequences.
Aims
A number of related studies have been carried out, aiming to:
- Identify the key stressors that impact upon surgical performance
- Identify surgeons’ requirements from a stress management training intervention
- Develop and validate the Imperial Stress Assessment Tool (ISAT) to measure stress in surgery
- Develop and validate an intervention taken from sports science, based on the concept of “mental practice” (i.e., the mental rehearsal of a task in the absence of relevant physical action) that enhances surgical skill and reduces stress levels
- Demonstrate quantitative improvements in surgical performance after using the intervention through a RCT set in a high fidelity simulated operating theatre
Methods
A range of methods and approaches have been used within this project including:
- Standardised systematic review methodology to identify the impact of stress on surgical performance
- Qualitative methodology (eg interviews and ethnographic observations) to elicit surgeons’ stressors and coping strategies in the operating theatre alongside their training needs.
- Quantitative methodology to develop and validate stress assessment tools and to assess the quality of the surgeons’ mental imagery processes
- Randomised controlled trial (RCT) methodology to test the efficacy of a stress management and performance enhancement intervention (mental practice) in a simulated operating theatre
Outputs
Stress and Surgical Performance outputs (PDF)
External collaborators
Professor Aidan Moran, University College Dublin