• Kanav Kahol, Mario J Leyba, Mary Deka, Vikram Deka, Stephanie Mayes, Marshall Smith, John J Ferrara, and Sethuraman Panchanathan.
• Simulation and Education Training Center, Banner Good Samaritan Medical Center, Phoenix, AZ 85016, USA.
• Am. J. Surg. 2008 Feb 1; 195 (2): 195-204.

BackgroundPrevious studies have explored the effect of fatigue on general psychomotor proficiency. However, studies specifically addressing the effect of fatigue on surgical residents' cognitive skills during simulated surgical exercises are lacking.MethodsThirty-seven surgical residents in both the precall and the postcall condition were tested for psychomotor and cognitive skill evaluation on a virtual-reality simulator with haptic feedback and hand-motion recording. To evaluate surgical skills, hand- and tool-movement smoothness, cognitive errors, and time to completion for specific tasks were analyzed.ResultsIn addition increased cognitive errors, a significant decrease (P < .01) was recorded in the proficiency variables of memory, attention, and intermodal coordination tasks when residents were in the postcall condition.ConclusionsFatigue and sleep deprivation cause a significant deterioration in the surgical residents' cognitive skills as measured by virtual reality simulation. Psychomotor skills are also negatively impacted during tasks that require a combination of psychomotor and cognitive skills.

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