title: The Effects of Music on Microsurgical Technique and Performance: A Motion Analysis Study.
abstract: BACKGROUND
  Music is commonly played in operating rooms (ORs) throughout the country. If a preferred genre of music is played, surgeons have been shown to perform surgical tasks quicker and with greater accuracy. However, there are currently no studies investigating the effects of music on microsurgical technique. Motion analysis technology has recently been validated in the objective assessment of plastic surgery trainees' performance of microanastomoses. Here, we aimed to examine the effects of music on microsurgical skills using motion analysis technology as a primary objective assessment tool.
  
  
  METHODS
  Residents and fellows in the Plastic and Reconstructive Surgery program were recruited to complete a demographic survey and participate in microsurgical tasks. Each participant completed 2 arterial microanastomoses on a chicken foot model, one with music playing, and the other without music playing. Participants were blinded to the study objectives and encouraged to perform their best. The order of music and no music was randomized. Microanastomoses were video recorded using a digitalized S-video system and deidentified. Video segments were analyzed using ProAnalyst motion analysis software for automatic noncontact markerless video tracking of the needle driver tip.
  
  
  RESULTS
  Nine residents and 3 plastic surgery fellows were tested. Reported microsurgical experience ranged from 1 to 10 arterial anastomoses performed (n = 2), 11 to 100 anastomoses (n = 9), and 101 to 500 anastomoses (n = 1). Mean age was 33 years (range, 29-36 years), with 11 participants right-handed and 1 ambidextrous. Of the 12 subjects tested, 11 (92%) preferred music in the OR. Composite instrument motion analysis scores significantly improved with playing preferred music during testing versus no music (paired t test, P <0.001). Improvement with music was significant even after stratifying scores by order in which variables were tested (music first vs no music first), postgraduate year, and number of anastomoses (analysis of variance, P < 0.01).
  
  
  CONCLUSIONS
  Preferred music in the OR may have a positive effect on trainees' microsurgical performance; as such, trainees should be encouraged to participate in setting the conditions of the OR to optimize their comfort and, possibly, performance. Moreover, motion analysis technology is a useful tool with a wide range of applications for surgical education and outcomes optimization.
authors.affiliation: From the *Division of Plastic and Reconstructive Surgery, Department of General Surgery, Stanford University Medical Center, Palo Alto, CA; and †Department of Plastic and Reconstructive Surgery, Royal Marsden Hospital, Fulham Road, London, England.
authors.forename: Afaaf
authors.initials: A
authors.lastname: Shakir
authors.forename: Arhana
authors.initials: A
authors.lastname: Chattopadhyay
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Paek
authors.forename: Rory B
authors.initials: RB
authors.lastname: McGoldrick
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Chetta
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hui
authors.forename: Gordon K
authors.initials: GK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D002983:Clinical Competence; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008866:Microsurgery; D009146:Music; D009873:Operating Rooms; D013518:Surgery, Plastic / Q000193:education*; D011795:Surveys and Questionnaires; D013996:Time and Motion Studies; D014741:Video Recording