Public release date: 6-Mar-2012 [ | E-mail | Share ]

Contact: Lisa Merkl lkmerkl@uh.edu 713-743-8192 University of Houston

George Kovacik ggkovacik@tmhs.org 832-667-5844

HOUSTON, March 6, 2012 Measure twice and cut once is a well-known phrase among surgeons, but this is not always what happens. To better prepare new surgeons for the operating room, University of Houston (UH) computer scientists are working with medical researchers at the Methodist Institute for Technology, Innovation and Education (MITIE) to improve existing training processes. At the core of their effort is understanding the role of stress on a surgeon's path to competency.

Ioannis Pavlidis, director of the Computational Physiology Laboratory at UH, Dr. Barbara Bass, chair of the department of surgery at The Methodist Hospital, and their colleagues describe their findings in a paper titled "Fast by Nature How Stress Patterns Define Human Experience and Performance in Dexterous Tasks." The article appears in Scientific Reports, the new open-access research publication from the Nature Publishing Group.

The group recently completed a three-year study funded by the National Science Foundation (NSF) that measured the stress levels of physicians during surgical training. In addition to the $500,000 from NSF, the researchers received a $200,000 grant from the John F. and Carolyn Bookout Fund to supplement the study.

Pavlidis and his colleagues developed a non-contact method of measuring stress and the body's response to threats or challenges. This new thermal imaging method is capable of quantifying performance and physiological stress indicators by measuring facial perspiration, revealing how a person reacts to a threatening situation. This is called a sympathetic response. Pavlidis, Bass and their teams were able to monitor these sympathetic responses of 17 surgeons 10 experienced and 7 novices while engaged in laparoscopic surgical training over the course of several months.

Bass, an authority in surgical education and director of MITIE, had long recognized that surgeons in training exhibit stress as they learn to perform surgical procedures. The team hypothesized this stress could be measured using the thermal facial mapping technology developed by the Pavlidis research laboratory and set out to determine if facial thermal stress would correlate with surgical skill performance.

"We found that regardless of experience level, surgeons attempt to perform tasks at the same speed," Pavlidis said. "This is counterintuitive, because you would expect common sense to tell a novice to be more careful and slow down in an effort to reduce errors. This was not the case in our study. Instead, the novices attempted the tool transferring, cutting and suturing tasks as fast as the experienced surgeons, thereby making many more errors due to their lack of experience to accommodate such speed."

This led Pavlidis and his colleagues to question why this was the case, and they discovered that high stress levels in novices were the likely trigger of fast behavior. When presented with a challenging task, he said, the basic human instinct of survival mode kicked in precipitating action, even if the speed of that action was counterproductive for the desired result.

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UH, Methodist team up to prepare surgeons for the operating room