Warm-up/exercises improve surgical performance

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Date Joined Sep 2009
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   Posted 2/5/2011 12:04 AM (GMT -6)   
General interest for all you fellow doctors  cool out there:

A prospective study published in the Journal of the American College of Surgeons (ACS is located here in Chicago, across the street from Northwestern (University) Memorial Hospital) says that surgeons should learn a lesson from athletes and musicians…and warm-up before they go to work. 

The researchers found that when surgeons took part in a series of exercises before operating, they performed better in surgery simulations.  Here's the abstract from PubMed





Effect of short-term pretrial practice on surgical proficiency in simulated environments: a randomized trial of the "preoperative warm-up" effect.


BACKGROUND: Surgery is a skill-driven discipline. While other high-stake professions with comparable cognitive and psychomotor skill requirements often use warm-up exercises for achieving better proficiency, the effects of such practice have not been investigated sufficiently in surgical tasks.

DESIGN: Subjects performed standardized exercises as a preoperative warm-up, after which the standardized exercises were repeated in a randomized order. In a variation to investigate the generalizability of preoperative warm-up, the experimental group was allowed to warm-up with the standardized exercises, after which a different task (electrocautery simulation) was performed. To investigate the effect of warm-up on fatigue, participants were involved in eight sessions (four before night call, four after night call), after which the tasks were repeated. Results were analyzed using ANOVA to plot differences between warm-up and followup condition.

RESULTS: All outcomes measures demonstrated statistically significant improvements after all of the post-warm-up exercises (p < 0.01), and were seen in all groups with differing experience levels. In addition, the simple warm-up exercises led to a significant increase in proficiency in followup electrocautery task for the experimental group when compared with the control group (p < 0.0001). There was also significant improvement in performance of the fatigued group to approximately baseline performance (p < 0.05), although they were not able to reach their optimal potential performance.

CONCLUSION: Preoperative warm-up for 15 to 20 minutes with simple surgical exercises leads to a substantial increase in surgical skills proficiency during followup tasks.








I helped my neighbor this week blow the snow off his driveway because his chest was healing from being cracked open in surgery.  This past fall he had a 9-hour vascular operation which started around 11pm (for torn aorta)...we had been out to dinner together, called ambulance to the restaurant, all night with him at the hospital, etc.  His surgeon had to be exhausted after working the whole day prior, and probably had a full day of office appointments the following day.  The following weekend, the surgeon flew to Hawaii for the Iron Man competition...the guy was in shape.  I'm guessing the doc probably did some exercises throughout the night to keep himself going.




P.S.   I'm not really a doctor...but, you already knew that.   'Cmon, don't be goofy...it's the internet!   cool

Post Edited (Casey59) : 2/4/2011 10:13:20 PM (GMT-7)

Worried Guy
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Date Joined Jul 2009
Total Posts : 3743
   Posted 2/5/2011 7:19 AM (GMT -6)   
Interesting. The only way there will ever be widespread acceptance of this is if Medicare, Blue Cross, etc. start a Charge Code for "Preoperative warm-up, 20 minutes" at a billing rate of $500 per hour.
When surgeons are permitted to have patients stacked like cord wood in the OR it is more lucrative to preform RP than toe touches. Some surgeons do 4 or 5 surgeries per day. How else can they boast numbers like "over 3000" surgeries. Maybe there should be a mandate that limits the maximum number of work hours in a 24 hour period, similar to the rules that pilots and truck drivers must follow.

I do believe stamina makes a difference. Fairly or unfairly one of the factors I had for choosing my surgeon was what kind of shape he appeared to be in. Reputation was most important, of course, but all things being equal, I would go with the guy with the best BMI.

Jeff (BMI =21)

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Date Joined Sep 2009
Total Posts : 3172
   Posted 2/5/2011 9:35 AM (GMT -6)   
Yup, if facing a 9-hour surgery, I'd be pleased to have the Iron Man dude in my corner. He doesn't need to get paid for warm-ups...he knows how to take care of himself.
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