Tschan, Franziska; Huguenin, M; Seelandt, JC; Semmer, Norbert; Keller, S; Nuoffer, Jean-Marc; Candinas, Daniel; Beldi, Guido (May 2014). Teamwork reduces physiological stress in junior surgeons. British journal of surgery, 101(S5), p. 8. John Wright & Sons
Objective:
The quality of teamwork depends not only on communication
skills but also on team familiarity and hierarchical structures. The aim of the
present study is to evaluate the physiological impact of close teamwork between
senior and junior surgeons performing elective open abdominal surgery for six
months in stable teams.
Methods:
Physiological measurements of the main and junior surgeons were
taken in a total of 40 procedures. Cumulative stress was assessed by the mea-
surements of urine catecholamines (Adrenaline, Noradrenaline, Dopamine, Metanephrine, Normetanephrine). Heart rate variability was measured to
assess temporal aspects of stress. The procedures were observed by a trained
team of work psychologists. Direct observations of distractors, team inter-
actions and communication were performed. Specific questionnaires were
filled by members of the surgical team that include surgeons, nurses and
anesthetists.
Results:
In junior surgeons, physiological stress is reduced over a period
of close collaboration. Case-related communication is not stressful. However,
tension within the surgical team is associated with increased levels of cat-
echolamine in the urine of the senior surgeon. The difficulty of the oper-
ation impacts on heart-rate variability of the junior but not of the senior
surgeon.
Conclusion:
Junior surgeons may require months of teamwork within one
stable team in order to reduce levels of physiological stress. Senior surgeons are
more resistant to stressful clinical situations compared to junior surgeons but
are vulnerable to tension within the surgical team.
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