765 USE OF WEARABLE SENSORS TO ASSESS STRESS RESPONSE IN ENDOSCOPY TRAINING

Abstract

Research in the surgical literature suggests that stress during procedural interventions may negatively impact technical performance and perhaps compromise patient safety. It is unknown if stress or perceived stress during endoscopy correlates with changes in biomechanical performance. Identifying kinematic manifestations of stress during endoscopic procedures may improve technical education of trainees and may facilitate in the development self-corrective behaviors for existing practitioners. Gastroenterology fellows performed the validated EndoBubble abstract psychomotor task on the GI Mentor II virtual reality simulator (Simbionix USA Corp., OH, USA). Flexible wearable sensors (Biostamp RCTM, mc10 Inc., Lexington, MA) were placed on the dorsum of both hands, dorsal section of both lower arms (2/3 distance from wrist to elbow) and forehead. The sensors recorded 3D linear accelerations and angular velocity. Range of changes to linear and angular acceleration were calculated from the raw signal collected during simulation. The validated Short-form State-Trait Anxiety Inventory and NASA Task Load Index were used to assess stress parameters, and all fellows completed the survey following the simulation. 19 gastroenterology fellows performed the simulated endoscopy task (14 were novice, first year trainees). Increased trainee stress particularly worry correlated significantly with right hand and arm rigidity. Acceleration of right hand adduction and abduction (r2 = -0 .729, p-value = 0.001) and vertical acceleration (r2 = -0 .753, p-value < 0.001) correlated significantly with self-reported worry. No association between perceived stress and total procedure time for this simple task was observed. Rigidity of the right hand and arm may be associated with the perception of stress and worry among trainees. The findings suggest decreased utilization of workspace, which may impact the ability to perform complex tasks. No component of perceived stress correlated to overall procedure time. This is the first study to identify and quantify the effect of stress on the kinematic performance of an endoscopy task. Awareness of psychomotor changes associated with stress may enhance endoscopy motor learning and individual coping skills when dealing with intraprocedural stressors.