Assessment of stress and teamwork in the operating room: an exploratory study

Hull, Louise; Arora, Sonal; Kassab, Eva; Kneebone, Roger; Sevdalis, Nick

doi:10.1016/j.amjsurg.2010.07.039

Cited by 74 publications

(56 citation statements)

References 17 publications

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“…The two most commonly used tools were the Observational Teamwork Assessment for Surgery (OTAS)34, 35, 36, 37, 38, 39 52 and the Non‐Technical Skills (NOTECHS) system27, 28, 29, 30, 31, 32, 33.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of methods for quantifying teamwork in the operating theatre

Marshall

Sykes

et al. 2018

BJS Open

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BackgroundTeamwork in the operating theatre is becoming increasingly recognized as a major factor in clinical outcomes. Many tools have been developed to measure teamwork. Most fall into two categories: self‐assessment by theatre staff and assessment by observers. A critical and comparative analysis of the validity and reliability of these tools is lacking.MethodsMEDLINE and Embase databases were searched following PRISMA guidelines. Content validity was assessed using measurements of inter‐rater agreement, predictive validity and multisite reliability, and interobserver reliability using statistical measures of inter‐rater agreement and reliability. Quantitative meta‐analysis was deemed unsuitable.ResultsForty‐eight articles were selected for final inclusion; self‐assessment tools were used in 18 and observational tools in 28, and there were two qualitative studies. Self‐assessment of teamwork by profession varied with the profession of the assessor. The most robust self‐assessment tool was the Safety Attitudes Questionnaire (SAQ), although this failed to demonstrate multisite reliability. The most robust observational tool was the Non‐Technical Skills (NOTECHS) system, which demonstrated both test–retest reliability (P > 0·09) and interobserver reliability (Rwg = 0·96).ConclusionSelf‐assessment of teamwork by the theatre team was influenced by professional differences. Observational tools, when used by trained observers, circumvented this.

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Section: Resultsmentioning

confidence: 99%

“…For example, Pearson's coefficient, although used by authors38 for quantifying correlation between raters for teamwork, is a tool for estimating correlations between variables that do not share a metric and variance, and, therefore, inappropriate for use to correlate observations of two raters on the same score56 57.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of methods for quantifying teamwork in the operating theatre

Marshall

Sykes

et al. 2018

BJS Open

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“…Several commonly used tools underwent minor modifications resulting in novel, but closely related, tools. The most frequently studied leadership assessment tools, including those with minor modifications, were NOTECHS (11; 13%), 54 48,51,81,89,113 and the Non-technical Skills for Surgeons (4; 5%). 49,[109][110][111] Many studies included multiple types of assessments (e.g., teamwork and clinical skills); however, only one study applied more than one leadership assessment tool.…”

Section: Assessment Tool Characteristicsmentioning

confidence: 99%

A Systematic Review of Tools Used to Assess Team Leadership in Health Care Action Teams

et al. 2015

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“…Surgeons' stress, even in optimized conditions like training on models, can negatively impact on psychomotor performance and safety in the operating theater [6,7,8,9]. Indeed, the operator's personal life-threatening complications like professional burnout have been described in obstetrics and gynecology residents [27] as in other specialties [28].…”

Section: Discussionmentioning

confidence: 99%

“…Surgery itself has been reported as a stressful situation significantly increasing urine biopyrin levels according to the duration of surgery and the amount of surgical blood loss [4]. Numerous stressors have been identified in surgical contexts such as distractions, communication failures, and deficient teamwork or equipment problems [5,6]. These stressful events can impair the surgeons' performance and compromise safety in surgery even though teaching, simulating on models, and self-flooding were developed by analogy to safety-critical industries [5,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Stress Experienced by Obstetrics and Gynecology Residents during Planned Laparoscopy: A Prospective, Multicentric, Observational, Blinded, and Comparative Study

Ducarme¹,

Bricou²,

Chanelles³

et al. 2015

Gynecol Obstet Invest

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Aims: To describe heart rate (HR) variations in surgical residents during laparoscopy and to assess their intraoperative stress. Methods: We performed a prospective, multicentric, observational, blinded, and comparative analysis of the HR in 75 obstetrics and gynecology residents during planned laparoscopy for infertility in five teaching hospitals with assisted reproductive technology centers. The surgical residents had neither heart disease nor were under medical treatment or using tobacco or drugs. We describe HR variations at 9 preselected operative steps using real-time noninvasive measures of the HR during laparoscopy. Results: Residents performed 124 laparoscopies for unexplained infertility. Their HR increased significantly during the introduction of the Palmer needle, umbilical port and second port, and during abdominopelvic exploration and dye test compared to the baseline HR, the HR after hand washing, at the end of surgery and during skin suture (91.6 ± 1.9, 104.8 ± 2.3, 95.3 ± 2.2, 93.7 ± 2.5, 90.7 ± 1.7 vs. 83.2 ± 1.6, 88.6 ± 1.9, 87.4 ± 2.1, 88.2 ± 1.9 bpm, respectively, p < 0.02). Conclusion: Our results point to a potential stress for the surgeon assessed by HR variations during planned laparoscopy compared to the baseline HR before surgery. This ‘static' stress can be repeated on the same day.

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Assessment of stress and teamwork in the operating room: an exploratory study

Cited by 74 publications

References 17 publications

Systematic review of methods for quantifying teamwork in the operating theatre

Systematic review of methods for quantifying teamwork in the operating theatre

A Systematic Review of Tools Used to Assess Team Leadership in Health Care Action Teams

Stress Experienced by Obstetrics and Gynecology Residents during Planned Laparoscopy: A Prospective, Multicentric, Observational, Blinded, and Comparative Study

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