Surgeon stress negatively affects their non-technical skills in the operating room

Abstract

Background: Poor surgeons' non-technical skills (NTS) and excessive stress and workload are known contributors to surgical errors. Our aim was to examine the relationship between surgeons' stress and workload, and their observed NTS intraoperatively.

Methods: Surgeon's NTS were rated in the operating room (OR) by trained observers. Surgeon stress, workload, familiarity with the OR team, prior experience, and case difficulty were captured. Relationships between variables were assessed.

Results: Fifteen surgeons participated in our study. Agreement among raters was high for NTS observations (ICC range = 0.56-0.96). Stress was negatively correlated with situation awareness, and workload was negatively correlated with decision making. Less familiarity among the team was correlated with higher stress.

Conclusions: Surgeons' stress and workload negatively affected their NTS in the OR. Further, unfamiliarity with the surgical team contributed to surgeon's stress. Methods to reduce surgeons' stress and workload such as mental skills training should be considered.

Keywords: Cognitive workload; Decision making; Non-technical skills; Situation awareness; Stress.