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CONTEXT Performing a clinical procedure requires the integration of technical clinical skills with effective communication skills. However, these skills are often taught separately. OBJECTIVES To explore the feasibility and benefits of a new conceptual model for integrated skills teaching. : Design A qualitative observation and interview-based study of(More)
BACKGROUND Effective teamwork is crucial for safe surgery. Failures in nontechnical and teamwork skills are frequently implicated in adverse events. The Observational Teamwork Assessment for Surgery (OTAS) tool assesses teamwork of the entire team in the operating room. Empirical testing of OTAS has yet to explore the content validity of the tool. STUDY(More)
The fatty acid composition of samples of breast milk obtained from 51 mothers (26 Malay, 15 Chinese, 10 Indian) residing in Penang, Malaysia was determined by gas chromatography. Despite living in close physical proximity the mothers from the three racial groups showed distinct cultural differences in dietary intake. These differences were reflected in(More)
OBJECTIVE To assess the effects of mental practice on surgical performance. BACKGROUND Increasing concerns for patient safety have highlighted a need for alternative training strategies outside the operating room. Mental practice (MP), "the cognitive rehearsal of a task before performance," has been successful in sport and music to enhance skill. This(More)
BACKGROUND Surgeons are often subject to excessive levels of acute stress that can impair their performance. Mental practice (MP) is a strategy used in other high-performance industries to alleviate anxiety. This study investigated if MP reduces stress in novice surgeons. STUDY DESIGN A prospective, randomized controlled design was used with 20 novice(More)
Distributed simulation (DS) is the concept of high-fidelity immersive simulation on-demand, made widely available wherever and whenever it is required. DS provides an easily transportable, self-contained 'set' for creating simulated environments within an inflatable enclosure, at a small fraction of the cost of dedicated, static simulation facilities.(More)
BACKGROUND Safe surgical practice requires a combination of technical and nontechnical abilities. Both sets of skills can be impaired by intra-operative stress, compromising performance and patient safety. This systematic review aims to assess the effects of intra-operative stress on surgical performance. METHODS A systematic search strategy was(More)
BACKGROUND Although the general literature on stress and performance is extensive, little is known about specific effects of stress in surgical practice. This qualitative study explored key surgical stressors, their impact on performance, and coping strategies used by surgeons. METHODS Individual in-depth semistructured interviews with surgeons were(More)
BACKGROUND Surgical skills are required by a wide range of health care professionals. Tasks range from simple wound closure to highly complex diagnostic and therapeutic procedures. Technical expertise, although essential, is only one component of a complex picture. By emphasising the importance of knowledge and attitudes, this article aims to locate the(More)
BACKGROUND Stressful events occur in the operating room (OR) with potentially severe consequences for patient safety. We recorded the incidence of these events in the OR, assessed the levels of stress that they caused, and investigated their detectability. METHODS Stressful incidents in the OR were recorded and rated in real time by an observer in 55(More)