Abstract
Background The amalgam of noises inherent to the modern-day operating room has the potential of diluting surgeon concentration, which could affect surgeon performance and mood and have implications on quality of care and surgeon resilience. Objective Evaluate the impact of operating room environmental noises on surgeon performance including fine motor dexterity, cognition, and mood. Methods 37 subjects were tested under three different environmental noise conditions including silence, a prerecorded soundtrack of a loud bustling operating room, and with background music of their choosing. We used the Motor Performance Series to test motor dexterity, neuropsychological tests to evaluate cognitive thinking, and Profile of Mood States to test mental well-being. Results Our results showed that typical operating room noise had no impact on motor dexterity but music improved the speed and precision of movements and information processing skills. Neurocognitive testing showed a significant decrement from operating room noise on verbal learning and delayed memory, whereas music improved complex attention and mental flexibility. The Profile of Mood States found that music resulted in a significant decrease in feelings of anger, confusion, fatigue, and tension along with decreased total mood disturbance, which is a measure of psychological distress. Loud operating room noise had a negative impact on feelings of vigor but no increase in total mood disturbance. Conclusion Our results suggest that loud and unnecessary environmental noises can be distracting to a surgeon, so every effort should be taken to minimize these. Music of the surgeons' choosing does not negatively affect fine motor dexterity or cognition and has an overall positive impact on mood and can therefore be safely practiced if desired.
Highlights
All surgeons are familiar with the near constant din of the modern-day operating room
Some surgeons even choose to alter the environmental noise in the operating room with background music. is amalgam of noises has the potential of diluting surgeon concentration from the task at hand, which could affect patient care. e relentless daily clamor could influence surgeon mood, which could mount over a career and impact resilience and contribute to burnout
Cognitive thinking skills were evaluated using a battery of standardized paper-pencil neuropsychological tests that have undergone extensive validation studies. e battery consisted of Hopkins Verbal Learning Test-Revised (Johns Hopkins University, Baltimore, Maryland), Brief Visuospatial Memory Test-Revised (Psychological Assessment Resources, Inc., Lutz, Florida), Trail Making Test Form B (Reitan Neuropsychological Laboratory, Tucson, Arizona), Symbol Digit Modalities Test (Western Psychological Services, Los Angeles, California), and the Stroop Test (Stoelting Company, Wood Dale, Illinois)
Summary
All surgeons are familiar with the near constant din of the modern-day operating room. Ambient noise can become raucous with the myriad of intrinsic and extrinsic noises inherent to the typical operating room. Intrinsic noises include necessary conversations, alarms, surgical device noise including suction and cautery machines, shift changes, and surgical case counts. Extrinsic sources of noise include unnecessary conversations, phones and beepers, computers, doors slamming, traffic throughout the room, and hallway noise. Some surgeons even choose to alter the environmental noise in the operating room with background music. Is amalgam of noises has the potential of diluting surgeon concentration from the task at hand, which could affect patient care. It is imperative to identify sources of potential surgeon distraction and mitigate these risks to patient safety and physician resilience
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