Effects of realistic distractions and interruptions on simulated surgical task performance Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/9019s5582

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  • Distractions and interruptions are common occurrences in an operating room (OR), but little is known about their effects on surgical task performance. Based on human factors research, it was hypothesized that realistic distractions and interruptions in an OR would adversely impact surgical task performance. Because of the concern of patient safety in an OR, research on distractions and disruptions needed to be conducted in a laboratory. Consequently, this research applied an advanced virtual reality simulator for a laparoscopic surgical procedure. The experimental design consisted of a two factor within-subjects test. The primary factor was the absence or presence of distractions and interruptions with the order being randomly counterbalanced. Four distractions and two interruptions were timed to occur during critical stages of the simulated surgical procedure. The secondary factor was the experience level of the surgeons. Eighteen surgical residents volunteered to participate in this study which yielded two experience levels of 2nd year and 3rd year residents. The results supported the hypothesis since major surgical errors were committed in 44% of the simulated surgical procedures when distracted and interrupted versus only 6% when not distracted or interrupted. This difference was significant with a p-value = 0.020. No effect was shown for surgical errors with respect to the different experience levels, possibly because of the limited separation in experience. For another type of error, 56% of the participants forgot to perform a prospective memory task when distracted and interrupted, while just 22% forgot in the non-distracted conditions. This difference was significant with a p value = 0.035. Although no significant effects were indicated for total task times due to distractions and interruptions, there was a significant time difference for a subtask that coincided with an interruption and distraction. Finally, no effect was shown with pre-specified measures of performer fatigue and personal distractibility traits. However, a significant dependency was observed with respect to time of day outcomes which may have been related to fatigue. Findings from this research are applicable in the training of surgeons to become more resistant to the effects of distractions and interruptions, thereby improving patient safety.
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