Utilizing a surgical sabermetrics framework to evaluate the impact of simulated operative crises on trainee cognitive load and non-technical skills

Abstract Intraoperative crisis events, such as haemorrhage or iatrogenic perforation, can cause considerable stress in the operating surgeon. Little standardized training exists for managing such events, especially for surgical trainees. Cognitive load (CogL) is the extent to which a task places demands on cognitive resources. Such resources are finite, and when overwhelmed, can lead to stress, which in turn can negatively affect intraoperative technical and non-technical performance. Surgical sabermetrics is a novel field that involves advanced analysis of data obtained from non-invasive physiological sensors measuring surgeon CogL, as well as audiovisual recordings of surgical procedures capturing surgeon technical and non-technical skills. This data-driven approach enhances understanding of factors that can improve, or worsen, surgical performance. ‘Managing Surgical Crises’ is a high-fidelity simulation course which exposes surgical trainees to standardized intraoperative crises with no risk to patient safety. This study aims to apply a sabermetrics framework to the ‘Managing Surgical Crises’ course to gain insight into trainee surgeon CogL and non-technical skills during the introduction and response to crisis events. Surgical trainees will be allocated to a simulated surgical crisis event and tasked with managing the scenario utilizing the Team, Environment, Assess/Analyse/Anticipate, Manage resources (TEAM) algorithm. A sabermetrics framework will be employed to collect quantitative data regarding CogL and non-technical performance. Full ethical approval has been obtained for this study. Dissemination of the results will be through conferences and publications in peer-reviewed journals.