Computational Physiology Laboratory, University of Houston, Houston, Texas, USA.
Institute of Reconstructive Surgery, Houston Methodist Hospital, Houston, Texas, USA.
Sci Rep. 2019 Feb 11;9(1):1747. doi: 10.1038/s41598-019-38727-z.
The negative impact of strong sympathetic arousal on dexterous performance during formal surgical training is well-known. This study investigates how this relationship might change if surgical training takes place as a hobby in an informal environment. Fifteen medical students volunteered in a 5-week training regimen and weekly performed two standardized microsurgical tasks: circular cutting and simple interrupted suturing. Time was taken and two independent reviewers evaluated the surgical proficiency. The State Trait Anxiety Inventory (STAI) and the NASA Task Load Index (NASA-TLX) questionnaires measured subjective anxiety and workload, respectively. A high-resolution thermal imaging camera recorded facial imagery, from which a computational algorithm extracted the perinasal perspiration signal as indicator of sympathetic arousal. Anxiety scores on STAI questionnaires were indifferent for all five sessions. The continuously measured arousal signal from the thermal facial imagery was moderate and did not correlate with surgical proficiency or speed. Progressive experience was the strongest contributor to improved skill and speed, which were attained in record time. It appears that dexterous skill acquisition is facilitated by the absence of strong arousals, which can be naturally eliminated in the context of informal education. Given the low cost and availability of surgical simulators, this result opens the way for re-thinking the current practices in surgical training and beyond.
强烈的交感神经兴奋对正式手术训练中灵巧表现的负面影响是众所周知的。本研究调查了如果手术训练作为一种业余爱好在非正式环境中进行，这种关系会如何变化。15 名医学生自愿参加了为期 5 周的训练计划，并每周进行两项标准化的显微外科任务：环形切割和简单间断缝合。记录时间，并由两名独立的评审员评估手术熟练程度。状态特质焦虑量表（STAI）和 NASA 任务负荷指数（NASA-TLX）问卷分别测量主观焦虑和工作量。高分辨率热成像摄像机记录面部图像，从该图像中，计算算法提取出作为交感神经兴奋指标的鼻周出汗信号。STAI 问卷中的焦虑评分在所有五次会议中都没有差异。从热面部图像中连续测量的兴奋信号处于中等水平，与手术熟练程度或速度无关。不断积累的经验是提高技能和速度的最强贡献者，这在创纪录的时间内完成。似乎灵巧技能的习得得益于强烈兴奋的缺失，而这种兴奋在非正式教育的背景下可以自然消除。鉴于手术模拟器的低成本和可用性，这一结果为重新思考当前的手术培训实践乃至更广泛的实践提供了思路。
