Relationship between physiologic and psychological measures of autonomic activation in operating room teams during a simulated airway emergency

Roy Phitayakorn; Rebecca D Minehart; Maureen W Hemingway; May C M Pian-Smith; Emil Petrusa

doi:10.1016/j.amjsurg.2014.08.036

Relationship between physiologic and psychological measures of autonomic activation in operating room teams during a simulated airway emergency

Am J Surg. 2015 Jan;209(1):86-92. doi: 10.1016/j.amjsurg.2014.08.036. Epub 2014 Oct 22.

Authors

Roy Phitayakorn¹, Rebecca D Minehart², Maureen W Hemingway³, May C M Pian-Smith², Emil Petrusa⁴

Affiliations

¹ Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA. Electronic address: [email protected].
² MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA.
³ MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; Department of Perioperative Services, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA.
⁴ Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA.

PMID: 25454964
DOI: 10.1016/j.amjsurg.2014.08.036

Abstract

Background: Emotional stability is important for individual and team performance during operating room (OR) emergencies. We compared physiologic and psychological anxiety assessments in OR teams during simulated events.

Methods: Twenty-two teams participated in a "cannot intubate/cannot ventilate" simulation. Participants completed the State-Trait Anxiety Inventory and wore a galvanic skin response (GSR) sensor. Differences in State-Trait Anxiety Inventory scores and GSR levels were analyzed. Anxiety scores were correlated with GSR levels.

Results: Resident physicians had significantly higher trait anxiety than the nurses, certified registered nurse anesthetists, and surgical technicians (43.9 ± 9.9 vs 38.3 ± 9.3, P < .01). Senior practitioners had significantly higher trait anxiety than junior practitioners (43.7 ± 9.6 vs 40.0 ± 9.9, P = .03). All groups showed significant increases in GSR. Psychological and physiologic data did not correlate.

Conclusions: Senior practitioners and residents have higher levels of baseline trait anxiety for unclear reasons. Also, OR team training results in physiological signs of anxiety that do not correlate to self-reported psychological measurements.

Keywords: Galvanic skin response; Nontechnical operating room performance; Operating room teamwork assessment tools; State–Trait Anxiety Inventory; Transprofessional/transdisciplinary operating room simulations.

Publication types

Clinical Trial

MeSH terms

Airway Obstruction / therapy*
Anxiety / diagnosis
Anxiety / etiology*
Anxiety / physiopathology
Emergencies
Female
Galvanic Skin Response
Humans
Male
Manikins
Nurses / psychology*
Operating Room Technicians / psychology*
Operating Rooms
Patient Care Team*
Physicians / psychology*
Psychological Tests
Stress, Psychological / diagnosis
Stress, Psychological / etiology*
Stress, Psychological / physiopathology