title: Operating theatre related syncope in medical students: a cross sectional study.
abstract: BACKGROUND
  Observing surgical procedures is a beneficial educational experience for medical students during their surgical placements. Anecdotal evidence suggests that operating theatre related syncope may have detrimental effects on students' views of this. Our study examines the frequency and causes of such syncope, together with effects on career intentions, and practical steps to avoid its occurrence.
  
  
  METHODS
  All penultimate and final year students at a large UK medical school were surveyed using the University IT system supplemented by personal approach. A 20-item anonymous questionnaire was distributed and results were analysed using the Statistical Package for Social Sciences, version 15.0 (Chicago, Illinois, USA).
  
  
  RESULTS
  Of the 630 clinical students surveyed, 77 responded with details of at least one near or actual operating theatre syncope (12%). A statistically significant gender difference existed for syncopal/near-syncopal episodes (male 12%; female 88%), p < 0.05. Twenty-two percent of those affected were graduate entry medical course students with the remaining 78% undergraduate. Mean age was 23-years (range 20 - 45). Of the 77 reactors, 44 (57%) reported an intention to pursue a surgical career. Of this group, 7 (9%) reported being discouraged by syncopal episodes in the operating theatre. The most prevalent contributory factors were reported as hot temperature (n = 61, 79%), prolonged standing (n = 56, 73%), wearing a surgical mask (n = 36, 47%) and the smell of diathermy (n = 18, 23%). The most frequently reported measures that students found helpful in reducing the occurrence of syncopal episodes were eating and drinking prior to attending theatre (n = 47, 61%), and moving their legs whilst standing (n = 14, 18%).
  
  
  CONCLUSIONS
  Our study shows that operating theatre related syncope among medical students is common, and we establish useful risk factors and practical steps that have been used to prevent its occurrence. Our study also highlights the detrimental effect of this on the career intentions of medical students interested in surgery. Based on these findings, we recommend that dedicated time should be set aside in surgical teaching to address this issue prior to students attending the operating theatre.
authors.affiliation: University of Nottingham Medical School, Queen's Medical Centre, UK. aabjamjoom@googlemail.com
authors.forename: A A B
authors.initials: AA
authors.lastname: Jamjoom
authors.forename: A
authors.initials: A
authors.lastname: Nikkar-Esfahani
authors.forename: J E F
authors.initials: JE
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D001007:Anxiety; D002321:Career Choice; D002982:Clinical Clerkship / Q000379:methods*; D003430:Cross-Sectional Studies; D005239:Fear; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D033182:Intention; D008297:Male; D009873:Operating Rooms; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires; D013575:Syncope / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology