Press Releases

Stress-free training may enhance surgical skill


Ioannis Pavlidis, Eckhard Pfeiffer Professor and director of the Computational Physiology Lab at UH, reports that students, approaching surgery for fun or as a hobby, had remarkable progress achieving dexterity levels similar to seasoned surgeons.
By Laurie Fickman, University of Houston | February 11, 2019

HOUSTON, Feb. 11 – University of Houston and Methodist Hospital researchers are reporting in Nature Scientific Reports that the best way to train surgeons is to remove the stress of residency programs and make surgery a hobby. Under relaxed conditions outside a formal educational setting, 15 first-year medical students, who aspired one day to become surgeons, mastered microsurgical suturing and cutting skills in as little as five hour-long sessions.

“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, Eckhard Pfeiffer Professor and director of the Computational Physiology Lab at UH. “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.” His partners on the project, Anthony Echo and Dmitry Zavlin, surgeons at Houston Methodist Institute for Reconstructive Surgery, gave brief instructions to the students at the beginning of the program.

Once the students began cutting and suturing at their mobile microsurgical simulators, Pavlidis and team tracked their stress levels by measuring sweat responses near the nose via thermal imaging. The students’ performance in the surgical drills was scored by two experts, based on video recordings.

In previous work Pavlidis and Methodist Hospital researchers found that surgical residents exhibited high stress levels during their formal training in surgical simulators. These high stress levels precipitated “fight or flight” responses, resulting in fast, mindless actions leading to errors and creation of a vicious cycle during the surgical drills.

In the present follow-up work, Pavlidis, Echo and Zavlin chose trainees outside the surgical establishment, without pressures and stakes, to examine what happens when environmental stress is neutralized and only stress associated with the challenging nature of the surgical drills is present.

“We removed stressful environmental factors, leaving only the inherent challenge of the surgical tasks, and discovered the physiologically-measured distress in the form of sympathetic arousal was moderate and unchanged throughout the five training sessions,” said Pavlidis. In contrast, Pavlidis reported in the previous study high stress levels in surgical residents and slow learning processes, where five training sessions brought no skill improvement. The main factor that sets the two studies apart is the educational context and stress associated with it.

In this study, where young surgery enthusiasts took up surgical training without the impact of environmental anxiety, skills were quickly acquired. Then once a skill like suturing is acquired, it won’t be forgotten, much like riding a bike.

“If you acquire a dexterous skill when you are not super stressed, you will acquire it better and faster, because `fight or flight’ responses are not there to mess things up” said Echo. “And once you have it, the skill won’t leave you. Like a bike, once you learn to bike, you bike,” Pavlidis added.

Future surgery residents with the skill acquired at a more opportune time would be able to focus on more advanced experiences inside the operating room. “Similar paradigms may apply to other artisan professions, upending training doctrines held sacred for generations” said Pavlidis.




Social Posts

profile_image

UTHealth

@UTHealth

RT @McGovernMed: Register now for the Pediatric Neuroscience Symposium at Children's Memorial Hermann Hospital on Saturday, May 4! #McGover…

25 mins ago
profile_image

CHI St. Luke's Health

@CHI_StLukes

Our love for #GreaterHouston is at the heart of everything we do. In our mission to create healthier communities, we’re sharing our favorite places to inspire health and happiness in our neighbors: https://t.co/oegrvNAWh9 #WeHeartHouston https://t.co/lO6veLnoku

51 mins ago
profile_image

Rice University

@RiceUniversity

The mystery of ‘mylk’ drove this Rice alumna coco-nuts! Luckily, a group of freshmen helped this entrepreneur find the right mix for shelf-stable vegan coconut milk. https://t.co/cYPiZxKVqT https://t.co/uIvYfwFJYA

54 mins ago
profile_image

BCMHouston

@bcmhouston

RT @BCMCancerCenter: Did you know you can still sign up for tomorrow's Lunch and Learn with Dr. Andrew Sikora hosted by @TheWomensFund? Be…

1 hour ago
profile_image

Texas Children's

@TexasChildrens

In honor of National Autism Awareness Month, Dr. Ruth Ann Luna shares the side of autism you don't see often: https://t.co/UuGS12BGqJ #texaschildrens

1 hour ago
profile_image

Harris Health System

@harrishealth

Going through menopause can be a bit like traveling in a new city without a map—or even a clear destination. In fact, you may not even realize you’re there until you’ve passed it. Here's how to better cope with this midlife milestone. https://t.co/6s25Aji4oe https://t.co/YUNpLFz3hh

1 hour ago
profile_image

Veterans Affairs

@DeptVetAffairs

.@VANatCemeteries Veteran sees duty at 35 locations https://t.co/aFx133klvV #VAntagePoint

1 hour ago
profile_image

Memorial Hermann

@memorialhermann

Let’s bring to light some surprising habits that could be damaging your skin: https://t.co/7VXEaHA9CT. https://t.co/dioqIgDfHD

1 hour ago
profile_image

UTHealth

@UTHealth

Vitiligo, Alopecia Merely Cosmetic? Think Again https://t.co/IrsX5jsoMq

2 hours ago
profile_image

MD Anderson Cancer Center

@MDAndersonNews

You don’t need any equipment to do #strengthtraining. Here are our tips for an at-home workout: https://t.co/B6LU00kIH9 @FocusedonHealth #endcancer https://t.co/fjCJ2TuPz5

2 hours ago
profile_image

BCMHouston

@bcmhouston

Running and enjoying treats in moderation are just some of the ways Dr. Christina Weng stays fit. See more of her healthy habits: https://t.co/ttuEhmpRmU #healthy #habits https://t.co/NNehV0jfJD

2 hours ago
profile_image

Texas Children's

@TexasChildrens

Join us for season two of @TexasChildrens podcast series, Outcomes! Every day incredible stories occur inside our walls, here are a few of those such stories.--> https://t.co/73SXLUB5Pv (Don't forget to subscribe!) https://t.co/fA7C3hgMgJ

2 hours ago
profile_image

Veterans Affairs

@DeptVetAffairs

RT @SecWilkie: I had the opportunity to share my command philosophy “Walk the Post" at VHA’s NLC meeting earlier today. I am honored to b…

2 hours ago
profile_image

UTHealth

@UTHealth

This could be why your hands are always so cold: https://t.co/T6p3d32EZS

2 hours ago
profile_image

TexasHeartInstitute

@Texas_Heart

RT @isiahcareyFOX26: Amazing story by the staff at TMC News and edited by our good friend @CindyGeorge https://t.co/KHcTqCVp1h!

3 hours ago