13Feb

Low Stress Medical Education May Improve Outcomes

The word “surgery” generally means opening a person’s body to fix something inside. To medical students and residents, though, “surgery” conjures up a highly challenging and competitive bootcamp for overachievers. Considering the stakes, one may think that all the stress that a surgical resident goes through would be warranted. People’s lives are at stake!

A team of researchers at University of Houston and Methodist Hospital in Texas recently completed an experiment to test this out, and they used some interesting technologies to make objective measurements.

Instead of going through the regular teaching methodology, a team of 15 first-year med students that were thinking of becoming surgeons were instead placed in a relaxed environment where they could practice microsurgical skills. Simple instructions were provided and there was no goals set to perform better than anyone else. Sessions lasted only a few hours, but the results showed surprising effectiveness of the low-stress approach.

“It appears that by removing external stress factors associated with the notoriously competitive and harsh lifestyle of surgery residencies, stress levels during inanimate surgical training plummet,” said Ioannis Pavlidis, director of the Computational Physiology Lab at University of Houston. “In five short sessions these students, approaching surgery for fun or as a hobby, had remarkable progress achieving dexterity levels similar to seasoned surgeons, at least in these drills.”

In order to assess whether the students were actually stressed or not, the researchers used thermal imaging to measure the amount of sweat produced under the nose. It is already well established that surgical residents often make mistakes when limited by all kinds of sources of stress, so medical students that were doing it mostly for fun had a much different response.

From the study abstract:

The continuously measured arousal signal from the thermal facial imagery was moderate and did not correlate with surgical proficiency or speed. Progressive experience was the strongest contributor to improved skill and speed, which were attained in record time. It appears that dexterous skill acquisition is facilitated by the absence of strong arousals, which can be naturally eliminated in the context of informal education. Given the low cost and availability of surgical simulators, this result opens the way for re-thinking the current practices in surgical training and beyond.

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