Background music contributes to error in the operating room

Abstract

Music and alarms have both been shown to improve performance in surgeons in the operating room (OR), but may interfere with anesthesiologist communication and performance. This experiment investigated the effects of music and alarms on speech intelligibility in a cognitively demanding multitask setting using simulated clinical, speech intelligibility, and visual vigilance tasks. Anesthesiology residents’ (n = 25) speech intelligibility performance was measured using the Coordinate Response Measure (CRM) in a 2 × 2 within-subjects design that varied background (simulated OR noise or OR noise with music, both normalized to 60 dB SPL) and alarm type (conventional or a novel auditory icon conforming to IEC 60601-1-8). Linear mixed-effects models showed music had a significant reduction in accuracy (p < 0.001), increased RT (p < 0.001), more instances of no response (p < 0.001). With music, average RT was increased by ∼0.2 s (95% CI: 0.07, 0.39), the odds of a correct response were reduced by ∼39% (95% CI: 25, 50), and the odds of no response were increased by 340% (95% CI: 246, 467). There was no evidence that alarm type impacted CRM performance. A device that modulates music volume during critical phases could reduce communication interference.