Auditory Stress Versus Mental Loading: The Effects on Laparoscopic Motor Skill Performance

(1) OBJECTIVE External auditory stress and internal mental stress may affect clinical practice. Our aim was to assess the specific impact of dichaotic music versus mental loading on novices performing laparoscopic tasks. (2) METHODS AND PROCEDURES Thirty naïve volunteers were recruited with no hearing or motor handicap. Volunteers were randomized to three simple tasks to be performed on a laparoscopic simulator: SurgicalSIM VR. Tasks were equal in difficulty and performed under three variable conditions: silence, auditory stress (dichaotic music) and mental loading (mental arithmetic tasks). Permutations of the conditions were created in order to account for a learning effect. Tasks were performed twice with a 10 minute break in between to test for memory consolidation and to accommodate baseline variability. Time until task completion and tip trajectory (path of tip through space) were recorded. (3) RESULTS Auditory stress and mental loading led to an increase in time to task completion when compared to silence (2.3 fold and 2.4 fold, respectively). Each led to a 1.8 and 2.0 fold increase in trajectory. Inter-person variability regarding task performance of the volunteers in response to auditory stress was greater compared to mental loading. In addition mental loading specifically affected recall of the procedure with an improvement accountable to memory consolidation of only 4% versus 32% in silence (p=0.021). (4) CONCLUSION Auditory stress and mental loading lead to prolonged operating time with diminished accuracy. More specifically, mental loading has a negative impact on memory consolidation resulting in lack of recall of learned skills. While our data does not allow any conclusions on music in the operating room, stressful distractions should be limited. Further research is necessary to understand the effects of stress on experts and the mechanisms that can be developed to counteract its negative effects on laparoscopic performance.

Session: Podium Presentation

Program Number: S125

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