Download PDF
Thorac Cardiovasc Surg 2023; 71(08): 596-604
DOI: 10.1055/s-0043-1776407
Original Cardiovascular

Impact of a 36-hour Nonstop Training Course on Academic, Physical, and Mental Skills as well as Psychological Stress Perception in Cardiac Surgery Residents

Tulio Caldonazo‡   *
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
,
Hristo Kirov‡   *
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
,
Ulrich Schneider
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
,
Andreas Beckmann
2   Department for Cardiac and Pediatric Cardiac Surgery, Heart Center Duisburg, Duisburg, Germany
,
K. W.
3   Special Forces, Federal Police, Berlin, Germany
,
Günter Weber
4   Institute for Conflict Research and Crisis Consulting, Munich, Germany
,
Regina Iglauer-Sander
5   Press Office, German Society for Thoracic and Cardiovascular Surgery, Berlin, Germany
,
Gloria Färber
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
,
Torsten Doenst
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
,
and on behalf of all Strong GermaN HeaRTS Participants › Author Affiliations Funding The course was funded by the German Network for Heart Research and Trials in Surgery (GermaN HeaRTS, DFG funding to T.D., DO602/15-1) and by Abbott. T.C. was funded by the Deutsche Forschungsgemeinschaft (DFG) Clinician Scientist Program OrganAge (funding number 413668513), by the Deutsche Herzstiftung (DHS, German Heart Foundation; funding number S/03/23), and by the Interdisciplinary Center of Clinical Research of the Medical Faculty Jena.
› Further Information
    Permissions and Reprints All articles of this category

Abstract

Background Making the right decision in stressful situations is required for goal-oriented action in cardiac surgery. Current labor laws prevent residents to be subjected to situations that test their stress tolerance. These situations often occur only later in the career. We simulated such conditions in a structured non-stop 36-hour cardiac surgical training course and assessed the participant's performance.

Methods Fourteen advanced residents/junior staff surgeons were selected. The course was conducted in collaboration with the national antiterror police forces that provided coaching for teamplay, leadership, and responsibility awareness. The candidates attended graded and evaluated workshops/lectures and performed academic and surgical tasks. Psychological and surgical skill assessments were conducted at times 0, 12, 24, 36 hours.

Results Progressive reductions in individual motivation, associated with increased stress and irritability levels, worsening mood, and fatigue were observed. Long- and short-term memory functions were unaffected and practical surgical performance even increased over time.

Conclusion Among the candidates, 36 hours of sleep deprivation did not lead to relevant changes in the skills required from a cardiac surgeon in daily life. Importantly, group dynamics substantially improved during the course, suggesting advances in the perception of responsibility and teamwork.

Keywords

cardiac surgery - cardiovascular medicine - surgical training - mental skills

Data Availability Statement

The data underlying this article will be kept digital and on file for the next 10 years.


* These authors contributed equally to this work.




Publication History

Received: 12 September 2023

Accepted: 12 October 2023

Article published online:
01 November 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Maher Z, Milner R, Cripe J, Gaughan J, Fish J, Goldberg AJ. Stress training for the surgical resident. Am J Surg 2013; 205 (02) 169-174
    CrossrefPubMedSearch in Google Scholar
  • 2 Wetzel CM, Kneebone RL, Woloshynowych M. et al. The effects of stress on surgical performance. Am J Surg 2006; 191 (01) 5-10
    CrossrefPubMedSearch in Google Scholar
  • 3 Anton NE, Montero PN, Howley LD, Brown C, Stefanidis D. What stress coping strategies are surgeons relying upon during surgery?. Am J Surg 2015; 210 (05) 846-851
    CrossrefPubMedSearch in Google Scholar
  • 4 Wick A, Beckmann A, Nemeth A. et al. Cardiac surgery residents training in Germany-Status quo and future prospects. J Thorac Cardiovasc Surg 2020; 159 (02) 579-587
    CrossrefPubMedSearch in Google Scholar
  • 5 Ellman PI, Law MG, Tache-Leon C. et al. Sleep deprivation does not affect operative results in cardiac surgery. Ann Thorac Surg 2004; 78 (03) 906-911 , discussion 906–911
    CrossrefPubMedSearch in Google Scholar
  • 6 Totaro P. Sleep deprivation and results in cardiac surgery: dangerous study with very dangerous conclusions. Ann Thorac Surg 2005; 80 (06) 2420 , author reply 2420–2421
    CrossrefPubMedSearch in Google Scholar
  • 7 Korte W, Merz C, Kirchhoff F. et al. Train early and with deliberate practice: simple coronary surgery simulation platform results in fast increase in technical surgical skills in residents and students. Interact Cardiovasc Thorac Surg 2020; 30 (06) 871-878
    CrossrefPubMedSearch in Google Scholar
  • 8 Machado L, Thompson LM, Brett CHR. Visual analogue mood scale scores in healthy young versus older adults. Int Psychogeriatr 2019; 31 (03) 417-424
    CrossrefPubMedSearch in Google Scholar
  • 9 Hinz A, Daig I, Petrowski K, Brähler E. Die Stimmung in der deutschen Bevölkerung: Referenzwerte für den Mehrdimensionalen Befindlichkeitsfragebogen MDBF. Psychother Psychosom Med Psychol 2012; 62 (02) 52-57
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Baghaei P, Ravand H, Nadri M. Is the d2 Test of Attention Rasch Scalable? Analysis With the Rasch Poisson Counts Model. Percept Mot Skills 2019; 126 (01) 70-86
    CrossrefPubMedSearch in Google Scholar
  • 11 Richardson JT. Measures of short-term memory: a historical review. Cortex 2007; 43 (05) 635-650
    CrossrefPubMedSearch in Google Scholar
  • 12 Fechir M, Schlereth T, Purat T. et al. Patterns of sympathetic responses induced by different stress tasks. Open Neurol J 2008; 2: 25-31
    CrossrefPubMedSearch in Google Scholar
  • 13 Alhola P, Polo-Kantola P. Sleep deprivation: Impact on cognitive performance. Neuropsychiatr Dis Treat 2007; 3 (05) 553-567
    PubMedSearch in Google Scholar
  • 14 Jackson ML, Gunzelmann G, Whitney P. et al. Deconstructing and reconstructing cognitive performance in sleep deprivation. Sleep Med Rev 2013; 17 (03) 215-225
    CrossrefPubMedSearch in Google Scholar
  • 15 Mehta KJ. Effect of sleep and mood on academic performance—at interface of physiology, psychology, and education. Humanit Soc Sci Commun 2022; 9: 16
    CrossrefPubMedSearch in Google Scholar
  • 16 Woodrow SI, Park J, Murray BJ. et al. Differences in the perceived impact of sleep deprivation among surgical and non-surgical residents. Med Educ 2008; 42 (05) 459-467
    CrossrefPubMedSearch in Google Scholar
  • 17 Passi T, Lukander K, Laarni J. et al. Effects of overnight military training and acute battle stress on the cognitive performance of soldiers in simulated urban combat. Front Psychol 2022; 13: 925157
    CrossrefPubMedSearch in Google Scholar