Music in the operating theatre: opinions of staff and patients of a Nigerian teaching hospital. Evaluation of a new method for librarian‐mediated literature searches for systematic reviews Effect of noise on auditory processing in the operating room. The Impact of Complications on Costs of Major Surgical Procedures: A Cost Analysis of 1200 Patients Laboratory-based vascular anastomosis training: a randomized controlled trial evaluating the effects of bench model fidelity and level of training on skill acquisition. The effect of defined auditory conditions versus mental loading on the laparoscopic motor skill performance of experts Surgical skill and complication rates after bariatric surgery. Prospective Randomized Study of the Effect of Music on the Efficiency of Surgical Closures. Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training. Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons The Mozart Effect on Task Performance in a Laparoscopic Surgical Simulator Effect of music on surgical skill during simulated intraocular surgery. The Effect of Music on Robot-Assisted Laparoscopic Surgical Performance The effect of music on biochemical markers and self-perceived stress among first-line nurses: a randomized controlled crossover trial. The Effects of Music on Microsurgical Technique and Performance: A Motion Analysis Study The effect of music on anaesthetists' psychomotor performance A Quality Improvement Study on Avoidable Stressors and Countermeasures Affecting Surgical Motor Performance and Learning
BACKGROUND The role of music during surgery has been studied , including its effect on theatre staff , users and patients . However , little attention has been paid to its application especially in our environment . METHODS It was a prospect i ve study , involving theatre staff , users , and patients . Their opinions on acceptability and the role of music in operating theatre were determined . Information was obtained by question naire . RESULTS There were 162 respondents ; age range 25 to 76 years ( median age 39 ) . There were 109 ( 67.2 % ) males and 53 ( 32.7 % ) female . One hundred and forty five ( 89.5 % ) respondents agree that music should be played in the operating theatre . One fifty eight , ( 97.5 % ) considered low tone of music to be most appropriate in the theatre while 3(1.9 % ) , and 1(0.6 % ) considered moderate and high tone respectively to be most appropriate . One hundred and sixteen , ( 71.6 % ) preferred  jazz music while 19(11.7 % ) reggae , 11(6.8 % ) African music , 13 ( 8.0 % ) others ( not specify ) , 2 ( 1.2 % ) classical , and 1(0.6 % ) Irish folk . The majority of the respondents were aware of the role of music in terms of its anxiolytic effect , reduction of stress and enhancement of performance when familiar music is played . CONCLUSION Music in the operating theatre has immeasurable effects . It can prevent distraction , minimize annoyance , reduce stress and diminish the anxiety of patients , staff and users Objective To evaluate and vali date the time of completion and results of a new method of search ing for systematic review s , the exhaustive search method ( ESM ) , using a pragmatic comparison . Methods Single‐line search strategies were prepared in a text document . Term completeness was ensured with a novel optimization technique . Macros in MS Word converted the syntaxes between data bases and interfaces almost automatically . We compared search characteristics , such as number of search terms and data bases , and outcomes , such as number of included and retrieved references and precision , from ESM search es and other Dutch academic hospitals identified by search ing PubMed for systematic review s published between 2014 and 2016 . We compared time to perform the ESM with a secondary comparator of recorded search times from published literature and contact with authors to acquire unpublished data . Results We identified 73 published Erasmus MC systematic review s and 258 published by other Dutch academic hospitals meeting our criteria . We pooled search time data from 204 other systematic review s. The ESM search es differed by using 2 times more data bases , retrieving 44 % more references , including 20 % more studies in the final systematic review , but the time needed for the search was 8 % of that of the control group . Similarities between methods include precision and the number of search terms . Conclusions The evaluated similarities and differences suggest that the ESM is a highly efficient way to locate more references meeting the specified selection criteria in systematic review s than traditional search methods . Further prospect i ve research is required BACKGROUND Effective communication is a critical component of patient care in the operative room ( OR ) . However , the presence of loud equipment , a large number of staff members , and music can contribute to high levels of background noise . In a setting in which crucial tasks are performed continuously , distractions and barriers to communication can result in harm to both patients and OR personnel . The purpose of this investigation was to simulate OR listening conditions and evaluate the effect of operating noise on auditory function . STUDY DESIGN This is a prospect i ve investigation of 15 subjects ranging from 1 to 30 years of operative experience . All surgeons had normal peripheral hearing sensitivity . The surgeons ' ability to underst and and repeat words were tested using the  Speech in Noise Test-Revised  in 4 different conditions chosen to simulate typical OR environments . These included quiet , filtered noise through a mask and background noise both with and without music . They were tested in both a tasked and in an untasked situation . RESULTS It was found that the impact of noise is considerably greater when the participant is tasked . Surgeons demonstrated substantially poorer auditory performance in music than in quiet or OR noise . Performance in both conditions was poorer when the sentences were low in predictability . CONCLUSIONS Operating room noise can cause a decrease in auditory processing function , particularly in the presence of music . This becomes even more difficult when the communication involves conversations that carry critical information that is unpredictable . To avoid possible miscommunication in the OR , attempts should be made to reduce ambient noise levels Objective : To assess the impact of postoperative complications on full in-hospital costs per case . Background : Rising expenses for complex medical procedures combined with constrained re sources represent a major challenge . The severity of postoperative complications reflects surgical outcomes . The magnitude of the cost created by negative outcomes is unclear . Patients and Methods Morbidity of 1200 consecutive patients undergoing major surgery from 2005 to 2008 in a tertiary , high-volume center was assessed by a vali date d , complication score system . Full in-hospital costs were collected for each patient . Statistical analysis was performed using a multivariate linear regression model adjusted for potential confounders . Results : This study population included 393 complex liver/bile duct surgeries , 110 major pancreas operations , 389 colon resections , and 308 Roux-en-Y gastric bypasses .  The overall 30-day mortality rate was 1.8 % , whereas morbidity was 53.8 % . Patients with an uneventful course had mean costs per case of US$ 27,946 ( SD US$ 15,106 ) . Costs increased dramatically with the severity of postoperative complications and reached the mean costs of US$ 159,345 ( SD US$ 151,191 ) for grade IV complications . This increase in costs , up to 5 times the cost of a similar operation without complications , was observed for all types of investigated procedures , although the magnitude of the increase varied , with the highest costs in patients undergoing pancreas surgery . Conclusion : This study demonstrates the dramatic impact of postoperative complications on full in-hospital costs per case and that complications are the strongest indicator of costs . Furthermore , the study highlights a relevant savings capacity for major surgical procedures , and supports all efforts to lower negative events in the postoperative course BACKGROUND Although there is growing evidence that practice on bench model simulators can improve the acquisition of technical skill in surgery , the degree to which these models have to approximate real-world conditions ( model fidelity ) to optimize learning is unclear . Previous research suggests that low-fidelity models may be adequate for novice learners . The purpose of this study was to assess the effect of model fidelity and surgical expertise on the acquisition of vascular anastomosis skill . METHODS Twenty-seven surgical residents participated in this institutional review board-approved study . Junior residents ( postgraduate year 1 and 2 ) and senior residents ( postgraduate year 4 or higher ) were r and omized into two groups : low-fidelity ( n = 13 ) and high-fidelity ( n = 14 ) model training . Both groups were given a 3-hour h and s-on training session : the low-fidelity group used plastic models , and the high-fidelity group used human cadaver arms ( brachial arteries ) to practice graft-to-arterial anastomosis . One week later , all subjects participated in an animal laboratory in which they performed a single vascular anastomosis on a live , anesthetized pig ( femoral artery ) . A blinded vascular surgeon scored c and i date performance in the animal laboratory by using previously vali date d end points , including a checklist and final product analysis score . RESULTS Acquisition of skill was significantly affected by model fidelity and level of training as measured by both the checklist ( P = .03 ) and final product analysis ( P = .01 ; Kruskal-Wallis ) . Specifically , junior residents practicing on high-fidelity models scored better on the checklist ( P = .05 ) and final product analysis ( P = .04 ) . Senior residents practicing on high-fidelity models scored better on final product analysis ( P < .05 ) . CONCLUSIONS Training in the laboratory does improve skill when assessed in a realistic setting . Both expertise groups showed better skill transfer from the bench model to live animals when practicing on high-fidelity models . For vascular anastomosis , it is important to provide appropriate model fidelity for trainees of different abilities to optimize the effectiveness of bench model training Background Music and noise are frequent occurrences in the operating room . To date , the effects of these auditory conditions on the performance of laparoscopic surgery experts have not been evaluated . Methods Eight internationally recognized experts were recruited for a crossover study . The experts were r and omized to perform three simple tasks on a laparoscopic simulator , SurgicalSIM VR . The tasks were equal in difficulty and performed under the following conditions : silence , dichaotic music ( auditory stress ) , classical music ( auditory relaxation ) , and mental loading ( mental arithmetic tasks ) . Permutations of the conditions were created to account for a learning effect . The tasks were performed twice to test for memory consolidation and to accommo date baseline variability . Time until task completion and task accuracy via instrument tip trajectory ( path of the tip through space ) were recorded . Performance was correlated with responses on the Brief Musical Experience Question naire ( MEQ ) . Results The study demonstrated that dichaotic music has a negative impact on time until task completion but not on task accuracy . In addition , memory consolidation of accuracy is negatively influenced . Classical music has a variable effect on experts ’ time until task completion , yet all the experts performed the tasks more accurately . Classical music had no effect on recall of a procedure . Mental loading increased time until completion , but did not affect accuracy or recall . The experience of music varied among experts and influenced how each of the conditions affected their performance . Conclusion The study demonstrated that , contrary to common belief , proficiency in surgery does not protect against stressful auditory influences or the influence of mental preoccupation . Interestingly , relaxing auditory influences such as classical music can even have a positive impact on the accuracy of experts . Previous musical experience could help to identify surgeons whose performance may be specifically affected by music or noise BACKGROUND Clinical outcomes after many complex surgical procedures vary widely across hospitals and surgeons . Although it has been assumed that the proficiency of the operating surgeon is an important factor underlying such variation , empirical data are lacking on the relationships between technical skill and postoperative outcomes . METHODS We conducted a study involving 20 bariatric surgeons in Michigan who participated in a statewide collaborative improvement program . Each surgeon su bmi tted a single representative videotape of himself or herself performing a laparoscopic gastric bypass . Each videotape was rated in various domains of technical skill on a scale of 1 to 5 ( with higher scores indicating more advanced skill ) by at least 10 peer surgeons who were unaware of the identity of the operating surgeon . We then assessed relationships between these skill ratings and risk-adjusted complication rates , using data from a prospect i ve , externally audited , clinical - outcomes registry involving 10,343 patients . RESULTS Mean summary ratings of technical skill ranged from 2.6 to 4.8 across the 20 surgeons . The bottom quartile of surgical skill , as compared with the top quartile , was associated with higher complication rates ( 14.5 % vs. 5.2 % , P<0.001 ) and higher mortality ( 0.26 % vs. 0.05 % , P=0.01 ) . The lowest quartile of skill was also associated with longer operations ( 137 minutes vs. 98 minutes , P<0.001 ) and higher rates of reoperation ( 3.4 % vs. 1.6 % , P=0.01 ) and readmission ( 6.3 % vs. 2.7 % ) ( P<0.001 ) . CONCLUSIONS The technical skill of practicing bariatric surgeons varied widely , and greater skill was associated with fewer postoperative complications and lower rates of reoperation , readmission , and visits to the emergency department . Although these findings are preliminary , they suggest that peer rating of operative skill may be an effective strategy for assessing a surgeon 's proficiency BACKGROUND Music is commonly played in operating theaters . Some surgeons believe music reduces stress and operative time , while others think music is a distraction and should be avoided . There is limited published evidence evaluating the effects of music on surgical performance . OBJECTIVE The goal of this study is to evaluate the effect of music on simple wound closure . METHODS Plastic surgery residents were asked to perform layered closures on pigs ' feet with and without their preferred music playing . Simple r and omization was used to assign residents to the music playing first or music playing second group . The time to complete the repair was measured and repairs were grade d by blinded faculty . Results were analyzed to determine significant differences in time to complete the task and quality of repair . Participants were retested in a second session with music played in the opposite order to evaluate consistency . RESULTS Listening to preferred music decreased repair time by 8 % for all plastic surgery residents ( p = 0.009 ) . Subgroup analysis demonstrated even more significant improvement in speed for senior residents ( PGY 4 - 6 ) , result ing in a 10 % decrease in repair time ( p = 0.006 ) . The quality of repair was also better in the music group , at 3.3 versus 3.1 ( p = 0.047 ) . Retesting revealed results remained significant whether music was played first or second . CONCLUSIONS Playing preferred music made plastic surgery residents faster in completing wound closure with a 10 % improvement in senior residents . Music also improved quality of repair as judged by blinded faculty . Our study showed that music improves efficiency of wound closure , which may translate to healthcare cost savings PURPOSE To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance . The secondary purpose of the study was to define which surgeons benefit from virtual reality training . DESIGN Multicenter masked clinical trial . PARTICIPANTS Eighteen cataract surgeons with different levels of experience . METHODS Cataract surgical training on a virtual reality simulator ( EyeSi ) until a proficiency-based test was passed . MAIN OUTCOME MEASURES Technical performance in the operating room ( OR ) assessed by 3 independent , masked raters using a previously vali date d task-specific assessment tool for cataract surgery ( Objective Structured Assessment of Cataract Surgical Skill ) . Three surgeries before and 3 surgeries after the virtual reality training were video-recorded , anonymized , and presented to the raters in r and om order . RESULTS Novices ( non-independently operating surgeons ) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32 % and 38 % , respectively-after virtual reality training ( P = 0.008 and P = 0.018 ) . More experienced cataract surgeons did not benefit from simulator training . The reliability of the assessment s was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training , respectively . CONCLUSIONS Clinical ly relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator . Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score Background Findings have shown that music affects cognitive performance , but little is known about its influence on surgical performance . The hypothesis of this r and omized controlled trial was that arousing ( activating ) music has a beneficial effect on the surgical performance of novice surgeons in the setting of a laparoscopic virtual reality task . Methods For this study , 45 junior surgeons with no previous laparoscopic experience were r and omly assigned to three equal groups . Group 1 listened to activating music ; group 2 listened to deactivating music ; and group 3 had no music ( control ) while each participant solved a surgical task five times on a virtual laparoscopic simulator . The assessed global task score , the total task time , the instrument travel distances , and the surgeons ’ heart rate were assessed . Results All surgical performance parameters improved significantly with experience ( task repetition ) . The global score showed a trend for a between-groups difference , suggesting that the group listening to activating music had the worst performance . This observation was supported by a significant between-groups difference for the first trial but not subsequent trials ( activating music , 35 points ; deactivating music , 66 points ; no music , 91 points ; p = 0.002 ) . The global score ( p = 0.056 ) and total task time ( p = 0.065 ) showed a trend toward improvement when participants considered the music pleasant rather than unpleasant . Conclusions Music in the operating theater may have a distracting effect on novice surgeons performing new tasks . Surgical trainers should consider categorically switching off music during teaching procedures The Mozart Effect is a phenomenon whereby certain pieces of music induce temporary enhancement in “ spatial temporal reasoning . ” To determine whether the Mozart Effect can improve surgical performance , 55 male volunteers ( mean age = 20.6 years , range = 16 - 27 ) , novice to surgery , were timed as they completed an activity course on a laparoscopic simulator . Subjects were then r and omized for exposure to 1 of 2 musical pieces by Mozart ( n = 21 ) and Dream Theater ( n = 19 ) , after which they repeated the course . Following a 15-minute exposure to a nonmusical piece , subjects were exposed to one of the pieces and performed the activity course a third time . An additional group ( n = 15 ) that was not cor and omized performed the tasks without any exposure to music . The percent improvements in completion time between 3 successive trials were calculated for each subject and group means compared . In 2 of the tasks , subjects exposed to the Dream Theater piece achieved approximately 30 % more improvement ( 26.7 ± 8.3 % ) than those exposed to the Mozart piece ( 20.2 ± 7.8 % , P = .021 ) or to no music ( 20.4 ± 9.1 % , P = .049 ) . Distinct patterns of covariance between baseline performance and subsequent improvement were observed for the different musical conditions and tasks . The data confirm the existence of a Mozart Effect and demonstrate for the first time its practical applicability . Prior exposure to certain pieces may enhance performance in practical skills requiring spatial temporal reasoning OBJECTIVE To evaluate the effect of Mozart music compared to silence on anterior segment surgical skill in the context of simulated intraocular surgery . DESIGN Prospect i ve stratified and r and omized noninferiority trial . PARTICIPANTS Fourteen ophthalmologists and 12 residents in ophthalmology . METHODS All participants were asked to perform 4 sets of predetermined tasks on the EyeSI surgical simulator ( VRmagic , Mannheim , Germany ) . The participants completed 1 Capsulorhexis task and 1 Anti-Tremor task during 3 separate visits . The first 2 sets determined the basic level on day 1 . Then , the participants were stratified by surgical experience and r and omized to be exposed to music ( Mozart sonata for 2 pianos in D-K448 ) during either the third or the fourth set of tasks ( day 2 or 3 ) . Surgical skill was evaluated using the parameters recorded by the simulator such as " Total score " and " Time " for both tasks and task-specific parameters such as " Out of tolerance percentage " for the Anti-Tremor task and " Deviation of rhexis radius from 2.5 mm , " " Roundness , " and " Centering " for the Capsulorhexis task . The data were analyzed using the Wilcoxon signed-rank test . RESULTS No statistically significant differences were noted between exposure and nonexposure for all the  Anti-Tremor task parameters as well as most parameters for the Capsulorhexis task . Two parameters for the Capsulorhexis task showed a strong trend for improvement with exposure to music ( " Total score " + 23.3 % , p = 0.025 ; " Roundness " + 33.0 % , p = 0.037 ) . CONCLUSION Exposure to music did not negatively impact surgical skills . Moreover , a trend for improvement was shown while listening to Mozart music Music is often played in the operating room to increase the surgeon ’s concentration and to mask noise . It could have a beneficial effect on surgical performance . Ten participants with limited experience with the da Vinci robotic surgical system were recruited to perform two surgical tasks : suture tying and mesh alignment when classical , jazz , hip-hop , and Jamaican music were presented . Kinematics of the instrument tips of the surgical robot and  surface electromyography  of the subjects were recorded . Results revealed that a significant music effect was found for both tasks with decreased time to task completion ( P = .005 ) and total travel distance ( P = .021 ) as well as reduced muscle activations ( P = .016 ) and increased median muscle frequency ( P = .034 ) . Subjects improved their performance significantly when they listened to either hip-hop or Jamaican music . In conclusion , music with high rhythmicity has a beneficial effect on robotic surgical performance . Musical environment may benefit surgical training and make acquisition of surgical skills more efficient AIM The aim of this study was to examine the effects of music on stress indices and to examine the association between music preference and stress . BACKGROUND Although clinical studies have demonstrated the effectiveness of music on stress , study results have been inconsistent . At the time of writing , no known publications had investigated the effects of preferred music on workers in high-stress professions such as nursing . METHODS Using a r and omized crossover controlled trial , 54 nurses were r and omly assigned to a music/chair rest sequence or chair rest/music sequence during the period February to June 2006 . Each intervention lasted for 30 minutes . Participants in the music condition listened to self-selected soothing music using headphones for 30 minutes . In the chair rest condition , participants sat quietly for 30 minutes . Serial measurements of participants ' heart rate , mean arterial pressure , finger temperature and cortisol levels were taken with a BP monitor and chemillumincent immunoassay every 15 minutes throughout the procedure . FINDINGS Compared with chair rest , participants had a lower perceived stress level , cortisol , heart rate , mean arterial pressure and higher finger temperature while listening to music ( P < 0·05 ) . Significant differences were also found between the two conditions in terms of post-test heart rate , cortisol levels , finger temperature and mean arterial pressure ( P < 0·05 ) . Music preference scores ranged between 7 and 10 , with a mean score of 8·81 ( sd = 1·05 ) , and was significantly associated with mean arterial pressure , cortisol levels , self-perceived stress and finger temperature . CONCLUSION The findings provided evidence for nurses to use soothing music as a research -based nursing intervention for stress reduction 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 vali date d in the objective assessment of plastic surgery trainees ' performance of microanastomoses . Here , we aim ed 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 r and omized . 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-h and ed 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 Music is frequently played in operating theatres , but may prove distracting to anaesthetists . We undertook a laboratory‐based study of the effects of music on the psychomotor performance of 12 anaesthetic trainees . Using part of the computer‐based PsychE psychomotor evaluation programme , we were unable to demonstrate any effect of self‐chosen music , silence , white noise or classical music on their performance in these tests Objective : To explore how the 2 most important components of surgical performance–-speed and accuracy — are influenced by different forms of stress and what the impact of music is on these factors . Background : On the basis of a recently published pilot study on surgical experts , we design ed an experiment examining the effects of auditory stress , mental stress , and music on surgical performance and learning and then correlated the data psychometric measures to the role of music in a novice surgeon 's life . Methods : Thirty-one surgeons were recruited for a crossover study . Surgeons were r and omized to 4 simple st and ardized tasks to be performed on the SurgicalSIM VR laparoscopic simulator ( Medical Education Technologies , Inc , Sarasota , FL ) , allowing exact tracking of speed and accuracy . Tasks were performed under a variety of conditions , including silence , dichotic music ( auditory stress ) , defined classical music ( auditory relaxation ) , and mental loading ( mental arithmetic tasks ) . Tasks were performed twice to test for memory consolidation and to accommo date for baseline variability . Performance was correlated to the brief Musical Experience Question naire ( MEQ ) . Results : Mental loading influences performance with respect to accuracy , speed , and recall more negatively than does auditory stress . Defined classical music might lead to minimally worse performance initially but leads to significantly improved memory consolidation . Furthermore , psychologic testing of the volunteers suggests that surgeons with greater musical commitment , measured by the MEQ , perform worse under the mental loading condition . Conclusions : Mental distraction and auditory stress negatively affect specific components of surgical learning and performance . If used appropriately , classical music may positively affect surgical memory consolidation . It also may be possible to predict surgeons ' performance and learning under stress through psychological tests on the role of music in a surgeon 's life . Further investigation is necessary to determine the cognitive processes behind these correlations
Introduction Beneficial effects of music have been described on several cognitive domains , task performance , stress , anxiety and pain .
Greater surgical skill is a factor that has been associated with improved patient outcome .
The aim of this systematic review is to assess the effect of music on surgical performance .