Stress training for the surgical resident

Am J Surg. 2013 Feb;205(2):169-74. doi: 10.1016/j.amjsurg.2012.10.007.


Background: Much effort in surgical education is placed on the development of clinical judgment and technical proficiency. However, little focus is placed on the management of stress associated with surgical performance. The inability to manage stress may lead to poor patient care, attrition from residency, and surgeon burnout.

Methods: A blinded, matched, comparison group study to evaluate the efficacy of an educational program designed to improve surgical resident performance during stressful scenarios was conducted. The experimental group (n = 11) participated in stress training sessions, whereas the control group (n = 15) did not. Both groups then completed a simulation during which stress was evaluated using objective and subjective measures, and resident performance was graded using a standardized checklist.

Results: Performance checklist scores were 5% higher in the experimental group than the control group (P = .54). No change existed in anxiety state according to the State Trait Anxiety Inventory (P = .34) or in heart rate under stress (P = .17) between groups.

Conclusions: There was a trend toward improved performance scoring but no difference in anxiety levels after stress training. However, 91% of residents rated the stress training as valuable.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Anxiety / etiology
  • Anxiety / physiopathology
  • Anxiety / prevention & control*
  • Clinical Competence* / standards
  • Clinical Competence* / statistics & numerical data
  • Female
  • General Surgery / education*
  • Heart Rate*
  • Humans
  • Internship and Residency* / standards
  • Internship and Residency* / trends
  • Male
  • Single-Blind Method
  • Stress, Psychological / etiology
  • Stress, Psychological / physiopathology
  • Stress, Psychological / prevention & control*