Classical but Not Rap Music Significantly Improves Transferability and Long-Term Acquisition of Laparoscopic Suturing Skills: A Randomized Controlled Trial

Abstract

Introduction Acoustic distractions have been shown to increase the level of stress and workload in the operating room (OR). Noise significantly reduces surgical performance, but experienced surgeons are able to reduce the acoustic perception of their surroundings to maintain a high level of performance in complex surgical tasks. However, music has been shown to improve learning and performance of complex motor skills. The aim of this study was to evaluate the influence of music on transferability and long-term acquisition of laparoscopic suturing skills.

Materials and Methods To evaluate the effects of music on training, subjects were asked to perform four surgeon's square knots on a bowel model within 30 minutes—prior and post 3 hours of hands-on training. To examine long-term skills, the same students were asked to perform a comparable, but more complex, task (four slip knots in a model of esophageal atresia) 6 months post initial training, as a follow-up measurement. Total time, knot stability (evaluated via tensiometer), suture accuracy, knot quality (Muresan scale), and laparoscopic performance (Munz checklist) were assessed.

Results Twenty-four students were included in the study; after simple randomization, 16 were trained while exposed to music (eight to Bach and eight to Bushido) and eight with traditional methods. Seven were lost due to follow-up. Both groups had comparable baseline characteristics and significantly improved after training, in all parameters assessed in this study. Subjects that trained with classical music were superior in terms of speed (p = 0.006), knot quality (p = 0.014), and procedural performance (p = 0.034) compared with controls.

Conclusion Music during acquisition of complex motor skills, like laparoscopic suturing and knot tying, is superior to traditional training. Especially music considered nondisturbing significantly improved speed, knot quality, and performance. Thus, incorporation of pleasant music into surgical skills training and the OR should be considered.

Keywords

laparoscopy - suturing - surgery - training - learning - music - bach - bushido

Authors' Contributions

S.M. conceptualized and designed the study, acquired the data, acted as course instructor, and approved the final manuscript as submitted. R.B. acquired the data, acted as course instructor, and approved the final manuscript as submitted. J.B. conceptualized and designed the study, acquired the data, performed statistics, and approved the final manuscript as submitted. L.K. acquired the data, acted as course instructor, and approved the final manuscript as submitted. J.W. acquired the data, acted as course instructor, and approved the final manuscript as submitted. K.R. conceptualized and designed the study and approved the final manuscript as submitted. M.B. conceptualized and designed the study, acquired the data, acted as course instructor, performed statistics, drafted the initial manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Note

Olympus Europe provided a location and the equipment to conduct the study, but no consumables.

Ethical Approval

The Medical Ethics committee of the Medical Association of Hamburg (Ethik-Kommission der Ärztekammer Hamburg) declared that no formal ethical approval was needed for this study.

Publication History

Received: 11 July 2019

Accepted: 01 November 2019

Article published online:
07 January 2020

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