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. 2020 Aug 13;7(4):188-193.
doi: 10.1136/bmjstel-2020-000631. eCollection 2021.

Biosensors, Biomarkers and Biometrics: a Bootcamp Perspective

Osian P James  1   2 , David B T Robinson  1 , Luke Hopkins  1   3 , Chris Bowman  1 , Arfon G M T Powell  4 , Chris Brown  1   5 , Damian M Bailey  6 , Richard J Egan  1   3 , Wyn G Lewis  1   7 ; Welsh Surgical Research Initiative
Collaborators, Affiliations

Biosensors, Biomarkers and Biometrics: a Bootcamp Perspective

Osian P James et al. BMJ Simul Technol Enhanc Learn. .

Abstract

Introduction: Competitive physical performance is routinely monitored by wearable technology (biosensors), yet professional healthcare is not, despite high prevalence of trainee stress and burnout, notwithstanding the corresponding risk to patient safety. This study aimed to document the physiological stress response of UK Core Surgical Trainees (CSTs) during simulation training.

Methods: CSTs (n=20, 10 male) were fitted with Vital Scout Wellness Monitors (VivaLNK, Campbell, California, USA) for an intensive 3-day training bootcamp. In addition to physiological parameters, CST demographics, event diaries and Maslach Burnout Inventory scores were recorded prospectively during exposure to three scenarios: interactive lectures, clinical skills simulation and non-technical (communication) training.

Results: Baseline heart rate (BHR, 60 bpm (range 39-81 bpm)) and baseline respiratory rate (14/min (11-18/min)) varied considerably and did not correlate (rho 0.076, p=0.772). BHR was associated with weekly exercise performed (66 bpm (<1 hour) vs 43 bpm (>5 hour), rho -0.663, p=0.004). Trainee response (standardised median heart rate vs BHR) revealed heart rate was related proportionately to lectures (71 bpm, p<0.001), non-technical skills training (79 bpm, p<0.001) and clinical skills simulation (88 bpm, p<0.001). Respiratory rate responded similarly (p<0.001 in each case). Heart rate during clinical skills simulation was associated with emotional exhaustion (rho 0.493, p=0.044), but maximum heart rate was unrelated to CSTs' perceived peak stressors.

Discussion: Stress response, as derived from positive sympathetic heart rate drive varied over two-fold, with a direct implication on oxygen uptake and energy expenditure, and highlighting the daily physical demands placed upon clinicians.

Keywords: Non-Technical Skills; Simulation Training; Stress; Surgical Education; Training.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Median (range) baseline heart rate (A) and respiratory rate (B), related to gender and weekly exercise undertaken.
Figure 2
Figure 2
Heart rate related to time of day and training session undertaken. CSS - clinical skills simulation, NTT - non-technical training.
Figure 3
Figure 3
Respiratory rate related to time of day and training session undertaken. CSS - clinical skills simulation, NTT - non-technical training.
Figure 4
Figure 4
Stress score related to time of day and training session undertaken. CSS - clinical skills simulation, NTT - non-technical training.
See this image and copyright information in PMC

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