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定义的听觉条件与精神负荷对专家腹腔镜手术技能表现的影响。

The effect of defined auditory conditions versus mental loading on the laparoscopic motor skill performance of experts.

机构信息

Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.

出版信息

Surg Endosc. 2010 Jun;24(6):1347-52. doi: 10.1007/s00464-009-0772-0. Epub 2009 Dec 24.

Abstract

BACKGROUND

Music and noise are frequent occurrences in the operating room. To date, the effects of these auditory conditions on the performance of laparoscopic surgery experts have not been evaluated.

METHODS

Eight internationally recognized experts were recruited for a crossover study. The experts were randomized to perform three simple tasks on a laparoscopic simulator, SurgicalSIM VR. The tasks were equal in difficulty and performed under the following conditions: silence, dichaotic music (auditory stress), classical music (auditory relaxation), and mental loading (mental arithmetic tasks). Permutations of the conditions were created to account for a learning effect. The tasks were performed twice to test for memory consolidation and to accommodate baseline variability. Time until task completion and task accuracy via instrument tip trajectory (path of the tip through space) were recorded. Performance was correlated with responses on the Brief Musical Experience Questionnaire (MEQ).

RESULTS

The study demonstrated that dichaotic music has a negative impact on time until task completion but not on task accuracy. In addition, memory consolidation of accuracy is negatively influenced. Classical music has a variable effect on experts' time until task completion, yet all the experts performed the tasks more accurately. Classical music had no effect on recall of a procedure. Mental loading increased time until completion, but did not affect accuracy or recall. The experience of music varied among experts and influenced how each of the conditions affected their performance.

CONCLUSION

The study demonstrated that, contrary to common belief, proficiency in surgery does not protect against stressful auditory influences or the influence of mental preoccupation. Interestingly, relaxing auditory influences such as classical music can even have a positive impact on the accuracy of experts. Previous musical experience could help to identify surgeons whose performance may be specifically affected by music or noise.

摘要

背景

音乐和噪音在手术室中频繁出现。迄今为止,这些听觉条件对腹腔镜手术专家手术表现的影响尚未得到评估。

方法

招募了 8 名国际知名专家进行交叉研究。专家们被随机分配到腹腔镜模拟器 SurgicalSIM VR 上完成三个简单任务。这些任务的难度相等,在以下条件下进行:安静、双重噪音(听觉压力)、古典音乐(听觉放松)和心理负荷(心算任务)。为了考虑学习效应,对条件进行了排列组合。任务执行两次以测试记忆巩固并适应基线变异性。记录完成任务的时间和仪器尖端轨迹(尖端在空间中的路径)的任务准确性。表现与简要音乐体验问卷(MEQ)的回答相关。

结果

研究表明,双重噪音对完成任务的时间有负面影响,但对任务准确性没有影响。此外,准确性的记忆巩固受到负面影响。古典音乐对专家完成任务的时间有可变的影响,但所有专家都更准确地完成了任务。古典音乐对程序的回忆没有影响。心理负荷增加了完成任务的时间,但不影响准确性或回忆。音乐体验在专家之间存在差异,并影响了每种条件对其表现的影响。

结论

该研究表明,与普遍看法相反,手术熟练程度并不能保护手术免受有压力的听觉影响或心理分心的影响。有趣的是,像古典音乐这样的放松听觉影响甚至可以对专家的准确性产生积极影响。以前的音乐经验可以帮助识别其表现可能受到音乐或噪音特别影响的外科医生。

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