Relationship between physiologic and psychological measures of autonomic activation in operating room teams during a simulated airway emergency - 09/12/14

Doi : 10.1016/j.amjsurg.2014.08.036

Roy Phitayakorn, M.D., M.H.P.E. ^a,^b,^⁎ , Rebecca D. Minehart, M.D. ^b,^c, Maureen W. Hemingway, R.N., M.S. ^b,^d, May C.M. Pian-Smith, M.D., M.S. ^b,^c, Emil Petrusa, Ph.D. ^a,^b
^a Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA
^b MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA
^c Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA
^d Department of Perioperative Services, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA

^∗Corresponding author. Tel.: +1-617-643-7935; fax: +1-617-643-4802.

Abstract

Background

Emotional stability is important for individual and team performance during operating room (OR) emergencies. We compared physiologic and psychological anxiety assessments in OR teams during simulated events.

Methods

Twenty-two teams participated in a “cannot intubate/cannot ventilate” simulation. Participants completed the State–Trait Anxiety Inventory and wore a galvanic skin response (GSR) sensor. Differences in State–Trait Anxiety Inventory scores and GSR levels were analyzed. Anxiety scores were correlated with GSR levels.

Results

Resident physicians had significantly higher trait anxiety than the nurses, certified registered nurse anesthetists, and surgical technicians (43.9 ± 9.9 vs 38.3 ± 9.3, P < .01). Senior practitioners had significantly higher trait anxiety than junior practitioners (43.7 ± 9.6 vs 40.0 ± 9.9, P = .03). All groups showed significant increases in GSR. Psychological and physiologic data did not correlate.

Conclusions

Senior practitioners and residents have higher levels of baseline trait anxiety for unclear reasons. Also, OR team training results in physiological signs of anxiety that do not correlate to self-reported psychological measurements.

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Keywords : Galvanic skin response, Transprofessional/transdisciplinary operating room simulations, Nontechnical operating room performance, Operating room teamwork assessment tools, State–Trait Anxiety Inventory

Plan

Methods

Subjects

Operating room simulation facilities and procedure

State–trait anxiety inventory

Galvanic skin response sensors

Research procedure

Statistical analysis

Results

Do different operating room professional groups report psychological anxiety or demonstrate physiologic activation at baseline and during the simulation session?

Do more experienced practitioners demonstrate and/or report lower physiologic and psychological stress in operating room team simulations?

Is there any difference between men and women in measured and reported stress?

What is the relationship between physiologic and psychological measures of stress in operating room team members during team training?

Comments

The authors declare no conflicts of interest.

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Vol 209 - N° 1

P. 86-92 - janvier 2015 Retour au numéro

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Relationship between physiologic and psychological measures of autonomic activation in operating room teams during a simulated airway emergency - 09/12/14

Abstract

Background

Methods

Results

Conclusions

Plan

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