Mastering instruments before operating on a patient: the role of simulation training in tool use skills.

Background: We examined the impact of tool complexity on surgeons' performance and evaluated the value of using a simulation-based program for reducing training cost.

Methods: Three pairs of surgical graspers with increasing mechanical complexity, which were designed for open, laparoscopic, and endoscopic procedures, were used in performing a simple object transportation task. Task times and mental workload of 17 surgeons were compared using all 3 variations of the graspers to test the impact of tool complexity on surgical performance.

Operative length independently affected by surgical team size: data from 2 Canadian hospitals.

Background: Knowledge of the composition of a surgical team is the premise for studying efficiency inside the operating room.

Methods: To investigate the team composition in general surgery procedures, we retrospectively reviewed procedures performed by an expert general surgeon in 2007-08 at 2 tertiary hospitals. For each patient, demographic characteristics, procedure type, team members and procedure length were extracted from intraoperative nursing records.