ArticleJournal of surgical education
Analysis of Mirrored Psychophysiological Change of Cardiac Surgery Team Members During Open Surgery.
Article in Journal of surgical education. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Evaluating surgeons' stress using heart rate variability during minimally invasive surgery for gastric cancer: a single-center prospective cohort study.Langenbeck's archives of surgery · 2026Article
- A novel multimodal, intraoperative cognitive workload assessment of cardiac surgery team members.The Journal of thoracic and cardiovascular surgery · 2025Article
- Turning Stress Into Success-Surgery as Professional Sport.JAMA surgery · 2025Article
- Multicenter Analysis of the Relationship Between Operative Team Familiarity and Safety and Efficiency Outcomes in Cardiac Surgery.Circulation. Cardiovascular quality and outcomes · 2024Article
- An Open-Source, Interoperable Architecture for Generating Real-Time Surgical Team Cognitive Alerts from Heart-Rate Variability Monitoring.Sensors (Basel, Switzerland) · 2023Article
- The Cognitive Relevance of a Formal Pre-incision Time-out in Surgery.ECCE ... : proceedings of the ... European Conference on Cognitive Ergonomics. European Conference on Cognitive Ergonomics · 2021Article
- Episodes of strain experienced in the operating room: impact of the type of surgery, the profession and the phase of the operation.BMC surgery · 2020Observational
- Sensors for Continuous Monitoring of Surgeon's Cognitive Workload in the Cardiac Operating Room.Sensors (Basel, Switzerland) · 2020Article
- Cognitive Engineering to Improve Patient Safety and Outcomes in Cardiothoracic Surgery.Seminars in thoracic and cardiovascular surgeryReview
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Authors and funding
5 authors.
Funding
Abstract
objectiveMirrored psychophysiological change in cognitive workload indices may reflect shared mental models and effective healthcare team dynamics. In this exploratory analysis, we investigated the frequency of mirrored changes, defined as concurrent peaks in heart rate variability (HRV) across team members, during cardiac surgery.
designObjective cognitive workload was evaluated via HRV collected from the primary surgical team during cardiac surgery cases (N = 15). Root mean square of the successive differences (RMSSD) was calculated as the primary HRV measure. Procedures were divided into consecutive nonoverlapping 5-minute segments, and RMSSD along with deviations from RMSSD were calculated for each segment. Segments with positive deflections represent above-average cognitive workload. Positive deflections and peaks across dyads within the same segment were counted.
settingData collection for this study took place in the cardiovascular operating room during live surgeries.
participantsPhysiological data were collected and analyzed from the attending surgeon, attending anesthesiologist, and primary perfusionist involved with the recorded cases.
resultsOf the 641 five-minute segments analyzed, 325 (50.7%) were positive deflections above average, concurrently across at least 2 team members. Within the 325 positive deflections, 26 (8%) represented concurrent peaks in HRV across at least 2 active team members. Mirrored peaks across team members were observed most commonly during the coronary anastomoses or valve replacement phase (N = 12).
conclusionsIn this pilot study, mirrored physiological responses representing peaks in cognitive workload were observed uncommonly across dyads of cardiac surgery team members (1.73 peaks/case on average). Almost half of these occurred during the most technically demanding phases of cardiac surgery, which may underpin teamwork quality. Future work should investigate interactions between technical and nontechnical performance surrounding times of mirrored peaks and expand the sample size.
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