B. Klein1, B. Saway2, H. Palmerton2, D. Tomlinson2, S. Svoboda2, G. Simonds1 2Virginia Tech Carilion School of Medicine,Roanoke, VA, USA 1Carilion Clinic,Division Of Neurosurgery,Roanoke, VA, USA
Introduction: Neurosurgeons must maintain unparalleled concentration in the operating room in order to avoid potentially disastrous complications. Unfortunately, on a busy surgical service, they are oftentimes bombarded with questions from operating room staff, residents, and consultants; forcing them to mentally multitask. We wanted to study whether these cognitive distractions could affect a neurosurgeon’s motor dexterity and therefore operative abilities, cognition and thereby clinical decision making abilities, or mood which could reflect burnout potential.
Methods: We tested the performance of 20 subjects in three environmental conditions: free of distraction, continuous simple reflexive questioning, and continuous complex processing questions. We utilized the Motor Performance Series to assess fine motor dexterity, paper-pencil neuropsychological tests to assess cognitive abilities, and the Profile of Mood States to evaluate for impact on mental well-being.
Results: Fine motor testing demonstrated that reflexive and complex questioning caused significant decrements in steadiness, precision, and mental processing; complex questioning also negatively impacted coordination. Neuropsychological testing showed considerable decline in verbal and visual memory, complex attention, mental flexibility, and psychomotor speed. Mood testing showed a significant decrease in feelings of vigor but no change in the total mood disturbance.
Conclusion: We believe that these results suggest that the barrage of questions commonly put upon operating neurosurgeons, are an unacceptable distraction as it could greatly impact motor and cognitive performance. Therefore, every effort should be made to provide an operative environment free of distraction to optimize patient safety.