title: Environmental Noise as an Operative Stressor During Simulated Laparoscopic Surgery.
abstract: OBJECTIVE
  This study aimed to determine what effect environmental noise has upon the psychological and physiological stress response of medical students during simulated laparoscopic surgery.
  
  
  METHODS
  An anonymous cohort of medical students were randomized into 2 arms and performed a laparoscopic task on a simulator. The "control" group performed the task in silence, whereas the "noise" group were exposed to an 80 dB verbal recording. Operator stress response was measured using a validated acute stress questionnaire and continuous heart rate (HR).
  
  
  RESULTS
  A total of 70 medical students participated. The "state" component of the State Trait Anxiety Inventory questionnaire increased significantly following the task in both groups with globally higher scores recorded in the noise group. Peak-resting HR values were significantly higher in the noise group. Mean-resting HR was significantly higher in the noise group.
  
  
  CONCLUSIONS
  Environmental noise in a simulated theater environment generates a measurable increase in operator stress response during laparoscopy.
authors.affiliation: *Department of Colorectal Surgery, Worcester Royal Hospital, Worcester Departments of †Orthopaedic Surgery ‡General Surgery, Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Waterland
authors.forename: Faisal S
authors.initials: FS
authors.lastname: Khan
authors.forename: Elgerta
authors.initials: E
authors.lastname: Ismaili
authors.forename: Chandra
authors.initials: C
authors.lastname: Cheruvu
mesh_terms: D000328:Adult; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects* / Q000193:education; D008297:Male; D009622:Noise / Q000009:adverse effects*; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult