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Human error in the OR and subjective mental workload of the surgeon

Session Details

Session Title: Practice Styles

Session Date/Time: Monday 07/10/2013 | 14:30-16:10

Paper Time: 14:54

Venue: Emerald (First Floor)

First Author: : K.Gerstmeyer GERMANY

Co Author(s): :    N. Marquardt   C. Treffenstädt   R. Gades        

Abstract Details


The surgeon’s actual cognitive performance is considered to be a key factor to successful surgery and is defined as the aggregated performance of several cognitive functions and processes including aspects of perception, attention and deliberate thinking. Is there are relation between the mental workload of the surgeon and the frequency of incidents and adverse events occurring during ophthalmic surgery?


Gerstmeyer K, Eye Clinic Minden, Germany Marquardt N, Rhine-Waal University of Applied Sciences, Kamp-Lintfort, Germany Treffenstädt C, Georg-August University, Institute of Psychology, Goettingen, Germany Gades R, Leuphana University of Lueneburg, Institute of Experimental Industrial Psychology, Germany


Longitudinal seven-center study, analyzing 827 ophthalmic operations, registration of safety critical incidents (CIRS), time of the occurrence, duration of the surgical treatment and the subjective mental workload of the surgeon using NASA Task Load Index (TLX) in form of a ten-degrees rating on six scales (mental, manual and temporal demand, performance, effort and frustration).


Our results demonstrate a clear link between the frequency of CIRS and the TLX subscales "performance" (p= .00), "effort" (p= .04) and at least a marginal statistical relationship with "frustration" (p= .053). In an initial examination we found no statistical connection between TLX and the time of the day. A multi-level analysis however confirmed a harmful effect from the duration of working hours for the mental workload of the surgeon (p=.049).


Surgery time has indirectly a negative impact on the mental state. Specific loading parameters such as "effort" and "performance" are associated with a higher frequency of safety-critical events and may have a predictive value. These results are important because we believe that limited cognitive performance, by diminishing non-technical as well as technical performance, increases the risk of human error induced incidents and accidents. Differences in the sample size, however suggest a tentative evaluation.

Financial Interest:


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