LeBlanc Vicki, Woodrow Sarah I, Sidhu Ravi, Dubrowski Adam
Wilson Centre, Faculty of Medicine, University of Toronto, Ontario, Canada.
Am J Surg. 2008 Jul;196(1):114-9. doi: 10.1016/j.amjsurg.2007.08.059.
This study was conducted to assess the effects of examination-induced stress on the technical performance of junior surgery residents.
Twelve first-year surgery residents completed 2 surgical tasks (skin excision, tracheotomy) in low- and high-stress condition (in-training examination--Objective Structured Assessment of Technical Skills [OSATS]). Residents rated their subjective stress levels on a 10-point Likert-like scale. Performances were videotaped and assessed by 3 blinded experts using checklist and global rating scales.
Residents reported moderately higher stress levels in the exam condition than in the low-stress conditions (P < .05). Their performance was rated higher in the exam condition on the checklist scales (P < .05) but not on the global rating scales (P = .79).
Residency in-training exams induce moderate stress levels in junior surgery residents and are accompanied by improvements in technical performance as assessed by checklist-based scales. There were no differences on the global rating scales due to stress conditions, suggesting that residents were better at following the itemized sequence of movements when stressed, but their overall global performance was not altered.
本研究旨在评估考试诱导的压力对初级外科住院医师技术操作的影响。
12名一年级外科住院医师在低压力和高压力条件下（培训中的考试——客观结构化技术技能评估[OSATS]）完成2项外科任务（皮肤切除、气管切开术）。住院医师使用10分制的类似李克特量表对其主观压力水平进行评分。操作过程被录像，并由3名不知情的专家使用检查表和整体评分量表进行评估。
住院医师报告称，考试条件下的压力水平略高于低压力条件下（P < .05）。在检查表量表上，他们在考试条件下的表现评分更高（P < .05），但在整体评分量表上则不然（P = .79）。
住院医师培训考试在初级外科住院医师中诱导出中等程度的压力水平，并且基于检查表的量表评估显示，压力伴随着技术操作的改善。由于压力条件的不同，整体评分量表上没有差异，这表明住院医师在有压力时更善于遵循逐项动作顺序，但他们的整体表现没有改变。
