Surgery is a skill-driven discipline.
While other high-stake professions with comparable cognitive and psychomotor skill requirements often use warm-up exercises for achieving better proficiency, the effects of such practice have not been investigated sufficiently in surgical tasks.
Subjects performed standardized exercises as a preoperative warm-up, after which the standardized exercises were repeated in a randomized order.
In a variation to investigate the generalizability of preoperative warm-up, the experimental group was allowed to warm-up with the standardized exercises, after which a different task (electrocautery simulation) was performed.
To investigate the effect of warm-up on fatigue, participants were involved in eight sessions (four before night call, four after night call), after which the tasks were repeated.
Results were analyzed using ANOVA to plot differences between warm-up and followup condition.
All outcomes measures demonstrated statistically significant improvements after all of the post-warm-up exercises (p < 0.01), and were seen in all groups with differing experience levels.
In addition, the simple warm-up exercises led to a significant increase in proficiency in followup electrocautery task for the experimental group when compared with the control group (p < 0.0001). There was also significant improvement in performance of the fatigued group to approximately baseline performance (p < 0.05), although they were not able to reach their optimal potential performance.
Preoperative warm-up for 15 to 20 minutes with simple surgical exercises leads to a substantial increase in surgical skills proficiency during followup tasks.
Journal of the American College of Surgeons
Department of Biomedical Informatics, Arizona State University, Tempe, AZ, USA.
J Am Coll Surg. 2009 Feb;208(2):255-68
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