Mental workload is defined as the amount of mental effort involved in performing a particular task. Mental workload has impact on clinical decision making and practice errors. We measured the impact of debriefing (feedback) on mental workload as it relates to surgical crisis scenarios, using a previously validated device for the measurement of mental workload.

Twenty junior surgical trainees (PGY1 and PGY2) from the University of Toronto participated in high-fidelity simulated post-operative crisis scenarios in a surgical ward environment (pre-test). Participants were randomized to either an instructor debriefing or no debriefing (control). The instructor debriefing group received feedback from the instructor, while the no debriefing group did not receive any feedback. Subjects then immediately managed a second simulated crisis (post-test). Mental workload was assessed in real-time using a previously validated wireless vibrotactile device. Mental workload was represented by the delay between the activation of the vibrotactile device and its deactivation by the subject by a push button. The comparison between the 2 groups in change in response time from pre-test to post-test was analyzed using the Mann-Whitney U Test.

Subject response time, as measured by the vibrotactile device, decreased significantly more after debriefing compared to no debriefing (1155ms ± 988ms vs. 351ms ± 2580ms, respectively; p<0.05).

Debriefing following simulated surgical crisis situations has an immediate impact in decreasing a trainee's mental workload during future surgical crisis situations. This spare mental capacity might help improve a trainee's clinical decision making; reduce human errors and/or direct attention towards acquiring technical/operative skills.