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      The impact of perioperative catastrophes on anesthesiologists: results of a national survey.

      Anesthesia and Analgesia
      Ovid Technologies (Wolters Kluwer Health)

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          Abstract

          Most anesthesiologists will experience at least one perioperative catastrophe over the course of their careers. Very little, however, is known about the emotional impact of these events and their effects on both immediate and long-term ability to provide care. In this study, we examined the incidence of perioperative catastrophes and the impact of these outcomes on American anesthesiologists.

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          Most cited references26

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          Compensatory control in the regulation of human performance under stress and high workload; a cognitive-energetical framework.

          This paper presents a cognitive-energetical framework for the analysis of effects of stress and high workload on human performance. Following Kahneman's (1973) model, regulation of goals and actions is assumed to require the operation of a compensatory control mechanism, which allocates resources dynamically. A two-level compensatory control model provides the basis for a mechanism of resource allocation through an effort monitor, sensitive to changes in the level of regulatory activity, coupled with a supervisory controller which can implement different modes of performance-cost trade-off. Performance may be protected under stress by the recruitment of further resources, but only at the expense of increased subjective effort, and behavioural and physiological costs. Alternatively, stability can be achieved by reducing performance goals, without further costs. Predictions about patterns of latent decrement under performance protection are evaluated in relation to the human performance literature. Even where no primary task decrements may be detected, performance may show disruption of subsidiary activities or the use of less efficient strategies, as well as increased psychophysiological activation, strain, and fatigue after-effects. Finally, the paper discusses implications of the model for the assessment of work strain, with a focus on individual-level patterns of regulatory activity and coping.
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            On error management: lessons from aviation.

              • Record: found
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              The evolution of Crew Resource Management training in commercial aviation.

              In this study, we describe changes in the nature of Crew Resource Management (CRM) training in commercial aviation, including its shift from cockpit to crew resource management. Validation of the impact of CRM is discussed. Limitations of CRM, including lack of cross-cultural generality are considered. An overarching framework that stresses error management to increase acceptance of CRM concepts is presented. The error management approach defines behavioral strategies taught in CRM as error countermeasures that are employed to avoid error, to trap errors committed, and to mitigate the consequences of error.

                Author and article information

                Journal
                10.1213/ANE.0b013e318227524e
                21737706

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