SURGERY
prompting pre-defined steps during surgery on a screen in real-time, with pictures, videos and voice-over along a predictive timeline (SPI Gmbh, Leipzig, Germany).10 Steps are validated via foot-pedal or voice command. Intra-operative events are collected along the surgical process, and observable results include improved digital synchronisation, team coordination, reduced variability and increased efficiency. The adherence to safety checks is ensured, as these are systematically embedded in the workflows and consistently prompt surgical teams. Additional AI capabilities open a new era of analytics on safe surgical performance and training.
Results
In order to mitigate the unprecedented reduction of training opportunities, we propose that MT and DW could have a role to play and that their synergy is worth exploring. There are strong similarities between mental training and digital workflows in terms of phases and steps, imagery, voice over and focus. Visualising and talking through steps, at the same pace, is a synchronised choreography that drives consistency throughout the procedure. However, even with early evidence emerging to support to the concept, its adoption is not a natural process. The pressure on delivery, in and post-crisis, may reduce further the openness to innovation, when it is most needed. An easy solution that is quick to implement could unlock the momentum.
Mental training was easy to develop and implement as per the protocol in our published randomised studies.
The COVID-19 pandemic has led to a dramatic decrease of surgical activities worldwide hindering performance at almost every stage of the learning curve with a possible impact on patient outcomes.
Mental training is in four stages, namely: identifying and learning by heart the key-steps; relaxation through abdominal respiration; subvocal rehearsal; and mental imagery, i.e picturing oneself walking and talking through the steps of a procedure. A digital workflow in the OR, requires
more time in its design and implementation. However, during the COVID-19, a digital workflow for PPE was developed in record time with Gif animation of donning and doffing (Fig.3). This mobile light version for tablet is a real-time theatre prompter that could reinforce the effect of mental practice.
Figure 2: Impact of SPI on surgical trainees’ performance over time 58 l
WWW.CLINICALSERVICESJOURNAL.COM NOVEMBER 2020
©Dr Lauscher-Berlin Charlité & Surgical process institute – Leipzig
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