Centre for Human Drug Research, Leiden, The Netherlands.
Patient Safety Committee, Association of Surgeons of the Netherlands, Utrecht, The Netherlands; Dept of surgery, Spaarne Gasthuis, Haarlem, The Netherlands.
J Surg Educ. 2018 Jul-Aug;75(4):968-977. doi: 10.1016/j.jsurg.2018.01.010. Epub 2018 Feb 2.
To develop a self-test to measure clinical fitness to perform in surgical residents, with alcohol-induced impairment as reference.
Observational, exploratory study to evaluate night shift-induced impaired performance in surgical residents followed by a randomized blinded, placebo-controlled, crossover study to evaluate impaired performance as a result of ethanol intoxication. Impairment was quantified using the Mini-NeuroCart, a psychomotor and cognitive test battery for assessment of subjective and objective measures of alertness, concentration, eye-hand coordination, mood, and self-assessed ability to perform. Surgical performance was tested in the randomized study with a laparoscopy surgical trainer.
Level-I trauma hospital and a clinical research unit.
Surgical residents (n = 12 for the observational study, n = 18 for the randomized study).
High alcohol levels (0.6gL) impaired adaptive tracking, reduced objective and subjective alertness, and increased slowness. Moreover, laparoscopy depth perception was impaired in the 0.6gL group. No significant within-subject correlation between subjective and objective measures of alertness was found. Performance of postcall surgeons was similar to, or even worse than, the performance of intoxicated surgeons.
The Mini-NeuroCart detected ethanol-induced performance effects that were similar to the effects of working a 14-hour night shift. Social (ethanol), personal (mood), and professional (laparoscopic skills) standards of fitness can in this manner be related to accepted deleterious effects of alcohol. The Mini-NeuroCart is, therefore, a potential noninvasive test for assessing "fitntness to perform" in healthcare professionals.
开发一种自我测试工具，以衡量外科住院医师的临床工作能力，以酒精所致损伤作为参考。
观察性、探索性研究，评估外科住院医师夜间工作导致的工作能力受损，随后进行随机双盲、安慰剂对照、交叉研究，以评估乙醇中毒导致的工作能力受损。使用 Mini-NeuroCart 评估警觉性、注意力、手眼协调、情绪和自我评估执行能力的主观和客观指标，来量化损伤程度。Mini-NeuroCart 是一种用于评估警觉性、注意力、手眼协调、情绪和自我评估执行能力的心理运动和认知测试工具包。在随机研究中，使用腹腔镜手术训练器测试手术表现。
一级创伤医院和临床研究单位。
外科住院医师（观察性研究 12 名，随机研究 18 名）。
高酒精水平（0.6gL）会损害适应性跟踪，降低客观和主观警觉性，并导致动作迟缓。此外，0.6gL 组的腹腔镜深度知觉受损。警觉性的主观和客观测量之间没有显著的个体内相关性。轮值手术医师的表现与醉酒手术医师相似，甚至更差。
Mini-NeuroCart 检测到乙醇引起的工作能力受损效应与连续工作 14 小时夜班引起的效应相似。以这种方式，可以将社会（乙醇）、个人（情绪）和专业（腹腔镜技能）标准的健康状况与公认的酒精有害影响联系起来。因此，Mini-NeuroCart 是一种潜在的非侵入性测试工具，可用于评估医疗保健专业人员的“工作能力”。
