Measuring factors impacting on surgical performance

Session Details

Session Title: Moderated Poster Session: New and Interesting

Venue: Poster Village: Pod 1

First Author: : M.Shaw MALTA

Co Author(s): :    J. Sandhu   A. Simpson   O. Crothers                 

Abstract Details

Purpose:

There is little work undertaken to objectively measure the impact of factors affecting surgical performance in Ophthalmology. The aim of this study was to undertake a systematic approach to measure the impact of extrinsic factors on microsurgical performance in the simulation setting.

Setting:

The study was conducted in a Tertiary Teaching Hospital: Ophthalmology Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Methods:

The participants were five Ophthalmology trainees and simulation testing was undertaken using the high-end virtual reality ‘Eyesi’ simulator for intraocular surgical training. The participants performed two microsurgical tasks, one involved hand tremor testing and the second involved bimanual navigation testing. Testing was undertaken to establish baseline scores in optimum conditions and testing was repeated with the following intraoperative factors were introduced: Operating table height too high and low, distraction, and hurrying the surgeon. Primary outcomes included i) Proficiency measurement score ii) Time to complete the task. These outcomes were recorded at baseline and with the intraoperative stressors.

Results:

A non-optimal operating table position had little effect on proficiency measurement scores. The mean time taken to complete the tasks was 9% lower from baseline with a low operating table position, and not significant with a raised table height. Operating with distraction had little effect on proficiency measurement scores, however the mean time to complete the tasks significantly increased, 15.8%. All participants were able to operate more expediently when in a hurry, and the mean reduction in operating time was 16.1%. However this concurrently resulted in a reduction in the mean proficiency measurement score of 8.0%.

Conclusions:

This study has demonstrated objectively the measurable impact on surgical performance of poor table height position, distraction and being hurried. Operating with distraction and with urgency has the most deleterious effect on surgical performance. An awareness of the impact of such factors when performing surgery contributes to our journey towards performing safe surgery and improving patient safety.

Financial Disclosure:

None