Debriefing decreases mental workload in surgical crisis: A randomized controlled trial

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Abstract

Background.

Mental workload is the amount of mental effort involved in performing a particular task. Crisis situations may increase mental workload, which can subsequently negatively impact operative performance and patient safety. This study aims to measure the impact of learning through debriefing and a systematic approach to crisis on trainees' mental workload in a simulated surgical crisis.

Methods.

Twenty junior surgical residents participated in a high-fidelity, simulated, postoperative crisis in a surgical ward environment (pretest). Participants were randomized to either an instructor-led debriefing, including performance feedback (intervention; n = 10) or no debriefing (control; n = 10). Subjects then immediately managed a second simulated crisis (post-test). Mental workload was assessed in real time during the scenarios using a previously validated, wireless, vibrotactile device. Mental workload was represented by subject response times to the vibrations, which were recorded and analyzed using the Mann-Whitney U test.

Results.

Participants in the debriefing arm had a significantly reduced median response time in milliseconds (post-test minus pretest −695, quartile range −2,136 to −297) compared to participants in the control arm (42, −1,191 to 763), (between-arm difference P = .049).

Conclusion.

Debriefing after simulated surgical crisis situations may improve performance by decreasing trainee's mental workload during a subsequent simulated surgical crisis.

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