The effect of defined auditory conditions versus mental loading on the laparoscopic motor skill performance of experts

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.

Eight internationally recognized experts were recruited for a crossover study. The experts were randomized 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 accommodate 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 Questionnaire (MEQ).

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.

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.