Surgeons who 'warm up' perform better during operations

Surgeons who warm up for 15 to 20 minutes with simple surgical exercises before performing an operation demonstrate a substantial increase in surgical proficiency, report the authors of a study from Arizona State University, Tempe.

The researchers found that a warm-up of both psychomotor and cognitive skills raises surgeons’ alertness to a higher level for surgical procedures and improves performance among fatigued surgeons.

“Warm-up exercises are a ‘common sense’ practice in many high-stakes professions, such as professional sports or dance,” said lead author Kanav Kahol, PhD. “This study begins to lay a scientific foundation for adopting this approach in routine surgical practice, which has become increasingly rigorous and demanding.”

Forty-six surgeons across varying specialties and experience levels were assigned standardized exercises as a preoperative warm-up. Afterward, the exercises were repeated in random order to examine proficiencies in psychomotor and cognitive skills involved in surgical procedures. Proficiencies were measured by gesture-level proficiency, hand-movement smoothness, tool-movement smoothness, time elapsed, and cognitive errors.

To investigate the general efficacy of the warm-up routine, the surgeons were assigned a different task, electrocautery simulation, after they completed the preoperative exercises. Researchers also examined the effect of the warm-up on fatigued participants on the basis of their performance before and after night call.

The results, published in the Journal of the American College of Surgeons (2009; 208:255-68), showed statistically significant improvements after all of the post warm-up exercises (ppp