title: Relationship between physiologic and psychological measures of autonomic activation in operating room teams during a simulated airway emergency.
abstract: BACKGROUND
  Emotional stability is important for individual and team performance during operating room (OR) emergencies. We compared physiologic and psychological anxiety assessments in OR teams during simulated events.
  
  
  METHODS
  Twenty-two teams participated in a "cannot intubate/cannot ventilate" simulation. Participants completed the State-Trait Anxiety Inventory and wore a galvanic skin response (GSR) sensor. Differences in State-Trait Anxiety Inventory scores and GSR levels were analyzed. Anxiety scores were correlated with GSR levels.
  
  
  RESULTS
  Resident physicians had significantly higher trait anxiety than the nurses, certified registered nurse anesthetists, and surgical technicians (43.9 ± 9.9 vs 38.3 ± 9.3, P < .01). Senior practitioners had significantly higher trait anxiety than junior practitioners (43.7 ± 9.6 vs 40.0 ± 9.9, P = .03). All groups showed significant increases in GSR. Psychological and physiologic data did not correlate.
  
  
  CONCLUSIONS
  Senior practitioners and residents have higher levels of baseline trait anxiety for unclear reasons. Also, OR team training results in physiological signs of anxiety that do not correlate to self-reported psychological measurements.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA. Electronic address: rphitayakorn@mgh.harvard.edu.
authors.forename: Roy
authors.initials: R
authors.lastname: Phitayakorn
authors.affiliation: MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA.
authors.forename: Rebecca D
authors.initials: RD
authors.lastname: Minehart
authors.affiliation: MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; Department of Perioperative Services, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA.
authors.forename: Maureen W
authors.initials: MW
authors.lastname: Hemingway
authors.affiliation: MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA.
authors.forename: May C M
authors.initials: MC
authors.lastname: Pian-Smith
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA; MGH Learning Laboratory, Massachusetts General Hospital, Harvard Medical School, 460 Wang ACC, 15 Parkman St., Boston, MA, USA.
authors.forename: Emil
authors.initials: E
authors.lastname: Petrusa
mesh_terms: D000402:Airway Obstruction / Q000628:therapy*; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004630:Emergencies; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D008297:Male; D008348:Manikins; D009726:Nurses / Q000523:psychology*; D009872:Operating Room Technicians / Q000523:psychology*; D009873:Operating Rooms; D010348:Patient Care Team; D010820:Physicians / Q000523:psychology*; D011581:Psychological Tests; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology
keywords: Galvanic skin response; Nontechnical operating room performance; Operating room teamwork assessment tools; State–Trait Anxiety Inventory; Transprofessional/transdisciplinary operating room simulations