We have multiple projects that seek to improve surgical safety through education. Not only can we do this through innovation, as in our MUS Errors work, but also through looking back, as in our Health Facts studies. Feel free to browse and learn.
Research
Health Outcome Research using Electronic Health Record Databases
A qualitative analysis of health data in different areas as they relate to surgical procedures and their outcomes. Some of the articles below are results of this research, including, “The Risk of Primary Uterine and Cervical Cancer After Hysteropexy” and “Risk Factors for Returning to the OR for a Second Surgery After Midurethral Sling for Stress Urinary Incontinence”, as well as, "The Impact of Preoperative HbA1c on reoperation rates in Women undergoing Surgery for Stress Urinary Incontinence and Pelvic Organ Prolapse", pictured here.
Some studies resulting in publications are
Scoping Review
Scoping review of studies that use video-recording as a methodology to conduct Health Professions Education research. This research is a collaborative effort with external researchers Elizabeth Littleton, PhD, Emily Huang, MD, Da Yeon Roo, MD and Patricia O’Sullivan, EdD.
Education through Ethnography
By observing and analyzing the lived experience of medical professionals and trainees, we can identify weaknesses and strengthen teaching.
"Beeps, Squeals, and Drones" is comprised of a number of projects that study how noise impacts teaching and learning in the operating room. Some of our recent publications and posters resulting from this include:
- Krishnan T, Rudy P, Viswanathan N, Brommelsiek M, Bachar A, Sutkin G. The Impact of Facial Personal Protective Equipment on Speech Intensity. Urogynecology, Nov 1, 2022. doi:10.1097/spv.0000000000001282. PMID: 36730870.
- Brommelsiek M, Krishnan T, Rudy P, Viswanathan N, Sutkin G. Human-Caused Sound Distractors and their Impact on Operating Room Team Function. World J Surg, March 2022. https://doi.org/10.1007/s00268-022-06526-9. PMID: 35347392.
Movement analysis studies the granular movements and non-verbal cues of surgeons in the teaching OR
- Rose C, Gangireddy S, Kirchhoff A, Gray M, Martin J, Brommelsiek M, Arnold L, Ye S, Sutkin G. Non-Verbal Patterns of Communication in the Operating Room. Poster Showcase at The University of Missouri Kansas City 7th Annual Vijay Babu Rayudu Quality & Patient Safety Day, May 29, 2020. Kansas City, MO. (No Link Available)
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1. Rose C, Bachar A, Martin J, Cheng AL, Sutkin G. Non-verbal Patterns of Teaching Communication in the Operating Room. Accepted Poster Presentation at the 2024 Association for Surgical Education Surgical Education Week. April 23-27, 2024. Orlando, FL.
Gender Differences in learning, teaching and communication are studied
- Ramprasad A, Casubhoy I, Meister M, Bachar A, Bethman B, Sutkin G. Language in the teaching OR: Expressing Confidence Versus Community. Trainee Quickshot Podium presentation at the 2023 Association for Surgical Education Annual Meeting, April 13-15, 2023, San Diego, CA
- Ramprasad A, Casubhoy I, Bachar A, Meister M, Bethman B, Sutkin G. Communal Versus Agentic Spoken Language Among Surgeons in the Operating Room. Poster Presentation at The University of Missouri Kansas City Health Sciences Student Research Summit, March 2, 2022. Kansas City, MO.
- Ramprasad A, Casubhoy I, Meister M, Bethman B, Bachar A, Sutkin G. Communal Versus Agentic Spoken Language Among Surgeons in the Operating Room. Poster presentation at the 9th Annual Vijay Babu Rayudu Quality & Patient Safety Day, May 6, 2022. Kansas City, MO.
Deixis delves deeper into communication, identifying unclear communication and its consequences
- Mahadev A, Bachar A, McKenzie A, Sutkin G. “Take a bit off the top here”: Ambiguity and vagueness in the operating room. Accepted for live presentation in the 5 Minute Linguist Event at the Linguistic Society of America 98th Annual Meeting, Jan 5-8, 2023, Denver, CO.
- Mahadev A, Bachar A, Karmarkar T, McKenzie A, Sutkin G. Implicit Communication and Miscommunication in Surgical Instruction. Podium presentation at the 2023 Association for Surgical Education Annual Meeting, April 13-15, 2023, San Diego, CA.
Silence studies non-verbal communication, as well as wondering when to speak up
- Brommelsiek M, Said T, Gray M, Kanter SL, Sutkin G. Absence or Presence: Silent Discourse in the Operating Room and Impact on Surgical Team Action. 2021 May. Am J Surg. 2020;S0002-9610(20)30586-9. doi:10.1016/j.amjsurg.2020.09.017. PMID: 32981652.
- Said T, Brommelsiek M, Gray M, Kanter S, Sutkin G. Absence or Presence: Silent discourse in the OR and its impact on surgical team action. Podium presentation at the 2020 Association for Surgical Education (ASE) Annual Meeting, April 28 - 30, 2020, Seattle, WA.
Interprofessional Communication in the OR
Speech Communication Interference
We use video ethnography to study inter-professional communication in the Operating Room. Our methodology is speech communication interference, when a loud OR interferes with one team member communicating a message to another. The OR contains loud machines and multiple overlapping conversations, and speech communication interference occurs 2-3 times per hour.
- Bachar A, Brommelsiek M, Simonson RJ, Chan YR, Davies A, Catchpole K, Sutkin G. Speech Communication Interference in the OR. J Surg Res. 2023. doi: 10.1016/j.jss.2023.11.064. PMID: 38142575.
- Sutkin G, Brommelsiek M, Bachar A, Simonson RJ, Chan YR, Davies A, Catchpole K. Speech Communication Interference: Surgical Team Requests and Impact on Patient Safety. Oral Presentation at the 2023 American College of Surgeons Clinical Congress, October 22-25, 2023, Boston, MA.
- Sutkin G, Bachar A, Brommelsiek M, Simonson R, Chan YR, Davies A, Catchpole K. Understanding Causes of Miscommunication in the Operating Room. Poster presentation at the 2024 HFES International Symposium on Human Factors and Ergonomics in Health Care, March 24-27, 2024, Chicago, IL.
- Sutkin G, Steele C, Brommelsiek M, Simonson R, Chan YR, Davies A, Catchpole K. Human Factors Approach to Improving Communication between Console Surgeon and Bedside Assistant. Oral presentation at the 2024 International Symposium on Human Factors and Ergonomics in Health Care Robotics Summit, March 24, 2024, Chicago, IL.
Improving Education and Safety through Simulation
Midurethral Sling Surgery Errors
We hypothesize that surgical error related to sub-optimal surgeon bio-mechanics can be quantified, predicted, and avoided by discrete changes in the kinematics of the surgeon’s shoulder, elbow, and wrist, and the surgical instrument’s spatio-temporal characteristics.
Publications resulting from this research are
Cognitive Strategies in High Risk Surgical Steps: The Role of Coping and Resilience
Qualitative study that explores the mental responses of surgeons during high risk surgical steps, how they develop strategies to alleviate stress and perform under pressure, how they perform under pressure without choking, and how performance under pressure is related to cognitive map formation and manipulation. We explore these themes through semi-structured interview in order to identify trends in strategies for coping and resilience that surgeons use to improve their performance.
This research was selected for a short communication and presented virtually at the Association for Medical Education in Europe 2021, as well as at our Vijay Rayadu Babu Quality Patient Safety Day. Cognitive mapping and its role in surgical resilience