Journal of Craniomaxillofacial Research 2016. 3(4):235-240.

Development of surgical skills and performance
Majid Beshkar, Mahboube Hasheminasab

Abstract


The main objectives of this article are to help surgeons understand some important factors that influence surgical performance, and provide them with some advice to improve their surgical skills. Progression of surgical skill through novice-expert continuum and factors that influence this
progression are discussed. One of these influential factors is the surgeon’s stress resilience. Scientific evidence regarding physiologic processes that underlie stress resilience and the effectiveness of psychological tools to improve this innate characteristic is reviewed. The impact of self-esteem
and the importance of deliberate practice on achieving higher levels of surgical performance are
also discussed. Innate characteristics are not rigid and can be improved by a variety of psychological tools including mental practice and self-talk. Stress management training programs and courses would be beneficial for surgeons with limited stress latitude and resilience. Deliberate practice is a powerful and efficient strategy to improve surgical performance.
Key words: Deliberate practice; Dexterity; Expert; Stress; Surgical performance; Surgical skill.

Keywords


Deliberate practice; Dexterity; Expert; Stress; Surgical performance; Surgical skill.

Full Text:

PDF

References


Gallagher AG, Leonard G, Traynor OJ. Role and feasibility of psychomotor and dexterity testing in selection for surgical training. ANZ J Surg2009;79:108-113.

Ericsson KA. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med. 2008;15:988-994.

Ericsson, KA. Deliberate practice and the acqui- sition and maintenance of expert performance in medicine and related domains. Acad Med.2004;79:S70-81.

Uemura M, Tomikawa M, Kumashiro R, et al.Analysis of hand motion differentiates expert and novice surgeons. J Surg Res. 2014;188:8-13.

Munz Y, Moorthy K, Bann S, et al. Ceiling effect in technical skills of surgical residents. Am J Surg.2004;188:294-300.

Gansky SA, Pritchard H, Kahl E, et al. Reliability and validity of a manual dexterity test to predict preclinical grades J Dent Educ. 2004;68:985-994.

Giuliani M, Lajolo C, Clemente L, et al. Is manual dexterity essential in the selection of dental stu- dents? Br Dent J. 2007;203:149-155.

Arora S, Sevdalis N, Nestel D, et al. The impact of stress on surgical performance: a systematic re- view of the literature. Surgery. 2010;147:318-330.

Wetzel CM, George A, Hanna GB, et al. Stress management training for surgeons-a random- ized, controlled, intervention study. Ann surg.2011;253:488-494.

Oken BS, Chamine I, Wakeland W. A systems approach to stress, stressors and resilience in hu- mans. Behav Brain Res. 2015;282:144-154.

Wetzel CM, Kneebone RL, Woloshynowych M, et al. The effects of stress on surgical performance. Am J Surg. 2006;191:5-10.

Winslow BD, Carroll MB, Martin JW, et al. Iden- tification of resilient individuals and those at risk for performance deficits under stress. Front Neu- rosci. 2015;9:328.

Arora S, Sevdalis N, Aggarwal R, et al. Stress im- pairs psychomotor performance in novice laparo- scopic surgeons. Surg Endosc. 2010;24:2588-2593.

Feder A, Nestler EJ, Charney DS. Psychobiology and molecular genetics of resilience. Nat Rev Neu- rosci. 2009; 10:446–457.

de Kloet ER, Joels M, Holsboer F. Stress and the brain: from adaptation to disease. Nature Rev Neurosci. 2005; 6:463–475.

Morgan CA 3rd, Southwick S, Hazlett G, et al.Relationships among plasma dehydroepiandroste rone sulfate and cortisol levels, symptoms of dis-sociation, and objective performance in humans exposed to acute stress. Arch Gen Psychiatry.2004;61:819–825.

Krishnan V, Han MH, Graham DL, et al. Molec- ular adaptations underlying susceptibility and re- sistance to social defeat in brain reward regions. Cell. 2007;131:391–404.

Yang C, Shirayama Y, Zhang JC, et al. Regional Differences in Brain-Derived Neurotrophic Factor Levels and Dendritic Spine Density Confer Resil- ience to Inescapable Stress. Int J Neuropsycho- pharmacol. 2015;18:pyu121.

Anacker C, Scholz J, O’Donnell KJ, et al. Neuro- anatomic Differences Associated with Stress Sus- ceptibility and Resilience. Biol Psychiatry. 2015; pii: S0006-3223(15)00657-5.

Tse YC, Montoya I, Wong AS, et al. A longitu- dinal study of stress-induced hippocampal vol- ume changes in mice that are susceptible or re- silient to chronic social defeat. Hippocampus.2014;24:1120-1128.

Campbell-Sills L, Cohan SL, Stein MB. Relation- ship of resilience to personality, coping and psy- chiatric symptoms in young adults. Behav Res Ther. 2006;44:585-99.

Gunthert K, Cohen L, Armeli S. The role of neurot- icism in daily stress and coping. J Pers Soc Psy- chol. 1999; 77:1087-1100.

Southwick SM, Vythilingam M, Charney DS. The psychobiology of depression and resilience to stress: implications for prevention and treatment. Annu Rev Clin Psychol. 2005;1:255–291.

Crewther BT, Shetty K, Jarchi D, et al. Skill ac- quisition and stress adaptations following lapa- roscopic surgery training and detraining in nov- ice surgeons. Surg Endosc. 2015; DOI 10.1007/ s00464-015-4584-0

Mohan A, Sharma R, Bijlani RL. Effect of medita- tion on stress-induced changesin cognitive func- tions. J Altern Complement Med. 2011;17:207 212.

Arora S, Aggarwal R, Moran A, et al. Mental prac- tice: effective stress management training for nov- ice surgeons. J Am Coll Surg. 2011;212:225-233.

Hatzigeorgiadis A, Zourbanos N, Galanis E, et al.Self-Talk and Sports Performance: A Meta-Analy- sis. Perspect Psychol Sci. 2011;6:348-356.

Heitland I, Klumpers F, Oosting RS, et al. Failure to extinguish fear and genetic variability in the human cannabinoid receptor 1. Transl Psychiatry.2012; 2:e162.

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.

Pajares F. Self-efficacy beliefs in academic settings. Rev Educ Res. 1996;66:543–578.

Artino AR. Academic self-efficacy: from educa- tional theory to instructional practice. Perspect Med Educ. 2012;1:76-85.

Platz F, Kopiez R, Lehmann AC, et al. The influ- ence of deliberate practice on musical achieve- ment: a meta-analysis. Front Psychol. 2014;5:646.

Ericsson KA, Krampe RT, Tesch-Römer C. The roleof deliberate practice in the acquisition of ex- pert performance. Psychol Rev. 1993;100:363–406.

van de Wiel MW, Van den Bossche P, Janssen S, et al. Exploring deliberate practice in medicine: how do physicians learn in the workplace? Adv Health Sci Educ Theory Pract. 2011; 16:81-95.

Wegner M, Koedijker JM, Budde H. The effect of acute exercise and psychosocial stress on fine motor skills and testosterone concentration in the saliva of high school students. PLoS One. 2014;9:e92953.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.