Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025
The Flush Model: A Novel Framework to Manage Surgeons' Mental Fatigue and Cognitive Load.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Laulan Pierrick, Fernandez Matthieu L G, Abet Emeric, Dimet Jérôme, Rimmele Ulrike
Аннотация
BACKGROUND: Mental fatigue significantly impairs surgeons' cognitive performance, compromising patient safety. However, surgical practice lacks an integrated framework to understand and mitigate this cognitive strain effectively.
CONCEPTUAL MODEL: We propose adapting the Flush model, initially developed for endurance sports, to surgical settings. This model conceptualizes mental fatigue through a dynamic analogy of a water tank composed of 4 main components: perceived fatigue (ballcock), fatigue accumulation (filling rate), fatigue recovery (drain rate), and a safety margin (security reserve). We detail how intrinsic cognitive load, extraneous stressors, physiological and psychological factors, and circadian influences collectively drive mental fatigue accumulation.
CLINICAL IMPLICATIONS: The Flush model clarifies how mental fatigue fluctuates during surgical procedures and highlights practical recovery methods such as brief mindfulness interventions, microbreaks, cognitive offloading, and ergonomics adjustments. It emphasizes maintaining a cognitive safety reserve to safeguard against errors during critical surgical phases, providing surgeons with actionable strategies to manage fatigue in real time.
FUTURE DIRECTIONS: We recommend empirical validation through real-time monitoring using physiological measures (eg, heart-rate variability, pupillometry) coupled with subjective assessments (eg, NASA Task Load Index, Surgery Task Load Index). Integrating Flush principles into surgical training, simulation programs, and institutional policies could foster a culture prioritizing cognitive performance and patient safety.
CONCLUSIONS: The Flush model provides a comprehensive, intuitive framework for understanding and addressing surgeons' mental fatigue. Its implementation promises to enhance cognitive resilience, reduce surgical errors, and improve both patient outcomes and surgeon well-being.
CONCEPTUAL MODEL: We propose adapting the Flush model, initially developed for endurance sports, to surgical settings. This model conceptualizes mental fatigue through a dynamic analogy of a water tank composed of 4 main components: perceived fatigue (ballcock), fatigue accumulation (filling rate), fatigue recovery (drain rate), and a safety margin (security reserve). We detail how intrinsic cognitive load, extraneous stressors, physiological and psychological factors, and circadian influences collectively drive mental fatigue accumulation.
CLINICAL IMPLICATIONS: The Flush model clarifies how mental fatigue fluctuates during surgical procedures and highlights practical recovery methods such as brief mindfulness interventions, microbreaks, cognitive offloading, and ergonomics adjustments. It emphasizes maintaining a cognitive safety reserve to safeguard against errors during critical surgical phases, providing surgeons with actionable strategies to manage fatigue in real time.
FUTURE DIRECTIONS: We recommend empirical validation through real-time monitoring using physiological measures (eg, heart-rate variability, pupillometry) coupled with subjective assessments (eg, NASA Task Load Index, Surgery Task Load Index). Integrating Flush principles into surgical training, simulation programs, and institutional policies could foster a culture prioritizing cognitive performance and patient safety.
CONCLUSIONS: The Flush model provides a comprehensive, intuitive framework for understanding and addressing surgeons' mental fatigue. Its implementation promises to enhance cognitive resilience, reduce surgical errors, and improve both patient outcomes and surgeon well-being.