title: The effect of stress on learning in surgical skill acquisition.
abstract: BACKGROUND
  An excessive level of stress and anxiety in medical education can have a negative impact on learning. In particular, the interaction between attending surgeons and trainees in the operating room could induce stress on trainees that is counterproductive, especially if the teaching style or feedback is unduly harsh or critical.
  
  
  OBJECTIVE
  To characterize the effects of stress resulting from attending-trainee interaction during surgical skill acquisition.
  
  
  METHODS
  Forty medical students learned to perform the FLS pattern-cutting task for the first time in one of four scenarios. In the control condition, no mentor was present. In the three experimental conditions, participants were observed, encouraged, or criticized by an expert surgeon.
  
  
  RESULTS
  Task performance, as well as physiological and subjective indicators of stress, were measured. Taking both speed and accuracy into account, participants who were criticized performed the worst on the task, and those who were encouraged performed best. Physiological and subjective measures indicated that the criticized participants experienced the highest level of stress and anxiety.
  
  
  CONCLUSIONS
  Even though providing constructive criticism to trainees is inevitable during the course of teaching, an exceedingly critical and negative mentoring style by attending physicians could be detrimental to trainees' acquisition of surgical skills.
authors.affiliation: a Wright State University , USA.
authors.forename: Jeff T
authors.initials: JT
authors.lastname: Flinn
authors.affiliation: a Wright State University , USA.
authors.forename: Amie
authors.initials: A
authors.lastname: Miller
authors.affiliation: a Wright State University , USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Pyatka
authors.affiliation: a Wright State University , USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Brewer
authors.affiliation: a Wright State University , USA.
authors.forename: Tamera
authors.initials: T
authors.lastname: Schneider
authors.affiliation: a Wright State University , USA.
authors.forename: Caroline G L
authors.initials: CG
authors.lastname: Cao
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004501:Education, Medical; D005260:Female; D000068156:Formative Feedback; D013502:General Surgery / Q000193:education*; D006801:Humans; D008297:Male; D013315:Stress, Psychological; D013337:Students, Medical / Q000523:psychology*; D013647:Task Performance and Analysis