title: Effects of cognitive distraction on performance of laparoscopic surgical tasks.
abstract: OBJECTIVE
  To quantify the effects of cognitive distraction on surgical task performance in residents and medical students using a laparoscopic surgical simulator.
  
  
  METHODS
  Within-subjects design.
  
  
  METHODS
  A surgical skills laboratory.
  
  
  METHODS
  Thirteen surgical residents and medical students who volunteered for the study.
  
  
  METHODS
  Subjects performed six tasks on the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR), under two different conditions (distracted and undistracted). Task order remained the same for all subjects, but the order of distraction was counterbalanced. In the distracted condition, distractions consisted of mental arithmetic problems posed sequentially so that subjects were continually distracted.
  
  
  METHODS
  Time to task completion, surgical errors committed, economy of motion, and overall performance scores were generated by the MIST-VR program software. Arithmetic error was not a factor in the overall performance score.
  
  
  RESULTS
  Time to task completion was significantly greater when subjects were distracted for all six tasks performed. Overall score and economy of motion were negatively affected by distraction but the effect did not reach th level of statistical significance. There was no effect of distract on surgical errors.
  
  
  CONCLUSIONS
  Cognitive distraction appears to negatively influence the performance of laparoscopic surgical tasks by increasing task completion time. Further study is required to determine what the effects would be on experienced surgeons and actual surgical outcomes.
authors.affiliation: Department of Surgery, Tufts-New England Medical Center, Boston, Massachusetts 02155, USA.
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Goodell
authors.forename: Caroline G L
authors.initials: CG
authors.lastname: Cao
authors.forename: Steven D
authors.initials: SD
authors.lastname: Schwaitzberg
mesh_terms: D000704:Analysis of Variance; D001288:Attention; D002983:Clinical Competence; D003198:Computer Simulation; D004501:Education, Medical / Q000379:methods; D004503:Education, Medical, Graduate / Q000379:methods; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D011597:Psychomotor Performance; D013647:Task Performance and Analysis; D014584:User-Computer Interface