title: Examination stress leads to improvements on fundamental technical skills for surgery.
abstract: BACKGROUND
  This study was conducted to assess the effects of examination-induced stress on the technical performance of junior surgery residents.
  
  
  METHODS
  Twelve first-year surgery residents completed 2 surgical tasks (skin excision, tracheotomy) in low- and high-stress condition (in-training examination--Objective Structured Assessment of Technical Skills [OSATS]). Residents rated their subjective stress levels on a 10-point Likert-like scale. Performances were videotaped and assessed by 3 blinded experts using checklist and global rating scales.
  
  
  RESULTS
  Residents reported moderately higher stress levels in the exam condition than in the low-stress conditions (P < .05). Their performance was rated higher in the exam condition on the checklist scales (P < .05) but not on the global rating scales (P = .79).
  
  
  CONCLUSIONS
  Residency in-training exams induce moderate stress levels in junior surgery residents and are accompanied by improvements in technical performance as assessed by checklist-based scales. There were no differences on the global rating scales due to stress conditions, suggesting that residents were better at following the itemized sequence of movements when stressed, but their overall global performance was not altered.
authors: Wilson Centre, Faculty of Medicine, University of Toronto, Ontario, Canada. vicki.leblanc@utoronto.ca
authors: Vicki
authors: V
authors: LeBlanc
authors: Sarah I
authors: SI
authors: Woodrow
authors: Ravi
authors: R
authors: Sidhu
authors: Adam
authors: A
authors: Dubrowski
mesh_terms: D002983:Clinical Competence; D062109:Dermatologic Surgical Procedures; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D013502:General Surgery / Q000193:education; D006801:Humans; D007396:Internship and Residency; D013315:Stress, Psychological; D013514:Surgical Procedures, Operative / Q000193:education*; D014140:Tracheotomy / Q000193:education