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A L Schueneman

Publications and source records attributed to A L Schueneman.

6 recordsLinked to original sources
PubMed1985

Age, gender, lateral dominance, and prediction of operative skill among general surgery residents.

Ability patterns and surgical proficiency were examined in matched groups of general surgery residents selected on the basis of age, gender, or hand preference from a population of 141 residents who had completed neuropsychologic tests of visuospatial, psychomotor, and stress tolerance abilities and had been rated on 12 aspects of technical skill exhibited during 1480 operative procedures. Older residents (ages 28 to 42 years) exhibited less motor speed (p less than 0.05) and coordination (p less than 0.005) and more caution in avoiding psychomotor errors (p less than 0.05) than did their younger counterparts. No differences were found for visuospatial abilities, stress tolerance, or rated surgical skill. These findings indicate that although age does appear to adversely affect pure motor skills, these are not important components of operative proficiency. Female residents exhibited superior (p less than 0.05) academic achievement (MCAT, Verbal and National Boards Part II) as compared with their male counterparts. They also excelled on a signal detection task requiring identification of visual patterns. However, the women scored less well (p less than 0.05) than men on a visuomotor task demonstrated to be a significant predictor of operative skill. Greater cautiousness in avoiding errors may be a contributing factor to their reduced efficiency on this task. In comparison to male controls, female residents received consistently lower surgical skills ratings, particularly on items measuring confidence and task organization. Left-handed residents were more reactive to stress (p less than 0.03), more cautious (p less than 0.04), and more proficient on a neuropsychologic test of tactile-spatial abilities (p less than 0.03) than right-handed counterparts. Although these traits correlated positively (p less than 0.05) with rated operative skill within the left-handed group, the group received consistently lower ratings than did right-handed residents. The inconvenience of assisting left-handed residents may overshadow attending surgeons' perceptions of their innate abilities. These findings demonstrate significant, neuropsychologically based differences among surgery residents that pose unique challenges to persons responsible for their selection and training.

Adult↗
PubMed1984

Neuropsychologic predictors of operative skill among general surgery residents.

The present study develops a rating scale method for evaluating operative skills, assesses the predictive utility of neuropsychologic tests of nonverbal cognitive and psychomotor abilities in accounting for individual differences in surgical skills, and compares the efficiency of these measures with those of traditional residency selection criteria. According to a multifactorial design, 120 general surgery residents were tested with a neuropsychologic test battery and then rated by attending surgeons on surgical skills exhibited during the course of 1445 surgical procedures. Analysis of the neuropsychologic battery resulted in three factors (complex visuo-spatial organization, stress tolerance, psychomotor abilities) that were statistically unrelated to traditional measures such as Medical College Admission Test and National Board scores. Multiple regression analyses indicated that academic predictors, taken alone, either do not correlate (National Board scores) or correlate negatively (Medical College Admission Test scores) with the surgery ratings. Conversely, neuropsychologic test scores show significant positive correlation (r = 0.68) with the ratings. When both sets of predictor variables are combined, a multiple regression coefficient of 0.80 is found with the ratings, with more than two thirds of the predictive power attributable to the neuropsychologic test scores. These tests may provide a useful addition to traditional methods of predicting operative skills.

Clinical Competence↗
PubMedDate not supplied

Sleep deprivation and resident performance.

Cognitive and complex motor performance may be impaired by extended sleep deprivation, but objective data concerning the effects in residents of the sleep deprivation engendered by usual hospital on-call schedules are scant and conflicting. We studied three cohorts of surgical residents (N = 26) who were on call every other night. Each resident kept a sleep diary, gave a self-assessment of motivation and fatigue, and underwent a battery of psychometric tests each morning for 18 or 19 days. The psychometric tests measured cognition, discernment, visual and auditory vigilance, and rapid eye-hand coordination. Sleep deprivation was defined as the lack of four hours of continuous sleep during the preceding 24 hours, and it occurred during 89% of the on-call nights. Daily testing in a repeated-measures design allowed each participant to serve as his or her own control. Sleep deprivation did not affect overall cognitive or motor performance. Further analysis of the correlation between sleep parameters (total sleep and longest uninterrupted sleep interval) and performance on each component of the psychometric test battery identified changes in performance on some tests but only trivial effects due to sleep. The assumption that sleep deprivation associated with usual on-call schedules impairs cognitive and motor performance of residents such that clinical care of patients may be compromised is not supported by our observations.

Adult↗