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Can fatigue affect acquisition of new surgical skills? A prospective trial of pre- and post-call general surgery residents using the da Vinci surgical skills simulator

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Abstract

Objective

To study the effects of fatigue on general surgery residents’ performance on the da Vinci Skills Simulator (dVSS).

Methods

15 General Surgery residents from various postgraduate training years (PGY2, PGY3, PGY4, and PGY5) performed 5 simulation tasks on the dVSS as recommended by the Robotic Training Network (RTN). The General Surgery residents had no prior experience with the dVSS. Participants were assigned to either the Pre-call group or Post-call group based on call schedule. As a measure of subjective fatigue, residents were given the Epworth Sleepiness Scale (ESS) prior to their dVSS testing. The dVSS MScore™ software recorded various metrics (Objective Structured Assessment of Technical Skills, OSATS) that were used to evaluate the performance of each resident to compare the robotic simulation proficiency between the Pre-call and Post-call groups.

Results

Six general surgery residents were stratified into the Pre-call group and nine into the Post-call group. These residents were also stratified into Fatigued (10) or Nonfatigued (5) groups, as determined by their reported ESS scores. A statistically significant difference was found between the Pre-call and Post-call reported sleep hours (p = 0.036). There was no statistically significant difference between the Pre-call and Post-call groups or between the Fatigued and Nonfatigued groups in time to complete exercise, number of attempts, and high MScore™ score.

Conclusion

Despite variation in fatigue levels, there was no effect on the acquisition of robotic simulator skills.

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Abbreviations

dVSS:

da Vinci Skills Simulator

ESS:

Epworth Sleepiness Scale

OSATS:

Objective structure assessment of technical skills

PGY:

Postgraduate year

RTN:

Robotic training network

ACGME:

Accreditation Council for Graduate Medical Education

VSS:

Virtual surgery simulator

VR:

Virtual reality

IRB:

Institutional Review Board

SPSS:

Statistical package of social sciences

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Acknowledgements

The authors are grateful for Craig Smith M.D. and his involvement in our study.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Mercer School of Medicine, Memorial University Medical Center, Savannah, GA, USA

    Weston Robison, Akshat Mehta & Eric Shaw

  2. Department of Surgery, Memorial University Medical Center, Mercer School of Medicine, Savannah, GA, USA

    Sonya K. Patel, John Allen & Christopher K. Senkowski

  3. Savannah Country Day School, Memorial University Medical Center, Savannah, GA, USA

    Tristan Senkowski

Authors
  1. Weston Robison
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  2. Sonya K. Patel
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  3. Akshat Mehta
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  4. Tristan Senkowski
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  6. Eric Shaw
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  7. Christopher K. Senkowski
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Corresponding author

Correspondence to Sonya K. Patel.

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Conflict of interest

Weston Robison, Sonya K. Patel, Akshat Mehta, Tristan Senkowski, John Allen, Eric Shaw, and Christopher K. Senkowski declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Robison, W., Patel, S.K., Mehta, A. et al. Can fatigue affect acquisition of new surgical skills? A prospective trial of pre- and post-call general surgery residents using the da Vinci surgical skills simulator. Surg Endosc 32, 1389–1396 (2018). https://doi.org/10.1007/s00464-017-5820-6

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  • DOI: https://doi.org/10.1007/s00464-017-5820-6

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