Effect of Postcall Fatigue on Surgical Skills Measured by a Robotic Simulator

Yamany, Tammer; Woldu, Solomon L.; Korets, Ruslan; Badani, Ketan K.

doi:10.1089/end.2014.0349

Cited by 17 publications

(15 citation statements)

References 23 publications

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“…[24][25][26][27][28] In the same context, a recent study has shown that postcall-related fatigue was associated with decreased surgical skills in the operative room. 29 More, as described earlier, if the resident is performing call duty at home and has worked for 18 hours during a 24-hour period, he shall be released from his regular schedule following his call period for at least 24 hours, it could be relevant to examine how often these situations happened. On-call duty service provides high impact learning opportunities, but loses some of his pedagogical benefits if the resident is subsequently absent of the clinical activities.…”

Section: Discussionmentioning

confidence: 99%

Urology residents on call: Investigating the workload and relevance of calls

Thériault

Marceau-Grimard²,

Blais

et al. 2017

CUAJ

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Introduction: On-call medical services assumed by residents represent many hours of hard work and no studies have documented what it really is. As part of an effort to ameliorate our on-call system, we examined phone calls received by residents on call. Our objectives were to evaluate the characteristics of phone calls received by residents on call (who, when, why, need to go to the hospital) and to determine residents' perception of these calls. We also looked into implementing strategies to reduce unnecessary calls. Method: We prospectively collected information about calls using a standardized reporting form with the participation of all residents (10) from a single urology program over two periods of four weeks from November 2014 to March 2015. Residents answered pre-and post-collecting period questionnaires. Results: A total of 460 calls were recorded on 97 on-call days in two on-call lists. There was a mean (median, range) of 3.5 (3, 0-12) calls per weeknight and 7.7 (6, 0-23) calls per weekend full day. Nintey-three calls (20%) led to the need for bedside evaluation and many of these were for new consultation (49%). The majority of calls originated from the clinical in-patient ward (49%) and emergency room (29%), and nurses (66%) and doctors (23%) most commonly initiated the calls. Calls between 11:00 pm and 8:00 am represented 13% of all calls. Most of the calls (77%) were perceived as relevant or very relevant. Most residents reported at least 80% of calls. Conclusions: Although likely representing an underestimate of the reality, we provide a first effort in documenting the call burden of Canadian urology residents.

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Section: Discussionmentioning

confidence: 99%

Urology residents on call: Investigating the workload and relevance of calls

Thériault

Marceau-Grimard²,

Blais

et al. 2017

CUAJ

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“…The mean MERSQI score for all included articles was 12.8, which falls short of the 14/18 mark that indicates ‘high quality’. Articles found to have a score of ≥14 are detailed in Table .…”

Section: Resultsmentioning

confidence: 99%

Implementing assessments of robot‐assisted technical skill in urological education: a systematic review and synthesis of the validity evidence

et al. 2018

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“…37 Evaluation of the impact of fatigue on technical performance yielded mixed results. While nine of the included studies showed a detrimental impact of fatigue on technical performance, [17][18][19][20][21][22][23][24][25] nine further studies had findings that showed no impact of fatigue. [26][27][28][29][30][31][32][33][34] A reversed action of fatigue that can lead to improvement in task performance has been described in the literature, 37 so it is interesting to note that the same phenomenon was noted in one of the studies.…”

Section: Discussionmentioning

confidence: 99%

“…Residents who were post-call took significantly longer (P,0.05) to complete the simulator task. 25 Simulator studies demonstrating no impact or improvement in surgical performance with fatigue…”

mentioning

confidence: 99%

Assessment of surgeon fatigue by surgical simulators

Tuwairqi¹,

Selter²,

Sikder³

2015

OAS

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Background:The impact of fatigue on surgical performance and its implications for patient care is a growing concern. While investigators have employed a number of different tools to measure the effect of fatigue on surgical performance, the use of the surgical simulator has been increasingly implemented for this purpose. The goal of this paper is to review the published literature to achieve a better understanding of evaluation of fatigue on performance as studied with surgical simulators. Methods: A PubMed and Cochrane search was conducted using the search terms "simulator", "surgery", and "fatigue". In total, 50 papers were evaluated, and 20 studies were selected after application of exclusion criteria. Articles were excluded if they did not use the simulator to assess the impact of fatigue on surgeon performance. Systematic reviews and case reports were also excluded. Results: Surgeon fatigue led to a consistent decline in cognitive function in six studies. Technical skills were evaluated in 18 studies, and a detrimental impact was reported in nine studies, while the remaining nine studies showed either no change or positive results with regard to surgical skills after experience of fatigue. Two pharmacological intervention studies reversed the detrimental impact of fatigue on cognitive function, but no change or a worsening effect was recognized for technical skills. Conclusion: Simulators are increasingly being used to evaluate the impact of fatigue on the surgeon's performance. With regard to the impact of fatigue in this regard, studies have demonstrated a consistent decline in cognitive function and mixed outcomes for technical skills. Larger studies that relate the simulator's results to real surgical outcomes could help residency programs and policy makers in structuring more efficient training.

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Effect of Postcall Fatigue on Surgical Skills Measured by a Robotic Simulator

Cited by 17 publications

References 23 publications

Urology residents on call: Investigating the workload and relevance of calls

Urology residents on call: Investigating the workload and relevance of calls

Implementing assessments of robot‐assisted technical skill in urological education: a systematic review and synthesis of the validity evidence

Assessment of surgeon fatigue by surgical simulators

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