Is perspiration a reliable indicator of surgical readiness?

When assessing the readiness of residents to perform surgery, the longstanding process has been for supervising surgeons to assess individual performance in the operating room. While this technique has proven effective for decades, the emergence of more regulatory bodies in surgical education has highlighted a need for a decidedly less subjective performance evaluator.

While a host of studies have been undertaken in an attempt to identify a more objective performance evaluator, including measuring the heart rates and blood flow to the brains of surgical residents, none have actually been deployed during a real life surgery.

That has now changed, however, thanks to the efforts of researchers at the University of Missouri who are currently in the middle of a five-year study measuring whether sweat levels could actually prove to be a reliable barometer of surgical readiness among residents.

As part of the study, 15 surgical residents have been wearing watch-like devices equipped with sensors to measure their “electrodermal activity” while performing standard gallbladder removal surgeries. These prospective surgeons will wear the sensors for the duration of their residency.

“During a stressful event, you have increased sweating that changes the amount of sodium in your skin, and sodium is an electrolyte that conducts electricity, so you look at the conductivity of skin,” said the lead researcher. “As the conduction potential rises, that is consistent with more stress.”

The primary objective of the long-term study is to identify trends indicative of when surgical residents reach a level of readiness comparable to their more experienced counterparts. To that end, the devices have been worn by staff members, who are serving as a sort of control group.

Prior to the performance of the gall bladder removal surgery, the residents and staff members are required to sit still and without interruption for roughly five minutes. The purpose of this sort of meditative state is to allow the sensors to gather a baseline stress level for comparison.

It will be fascinating to see what answers can be derived from this study. Here’s hoping it helps makes surgery a safer proposition.

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