Inattentional blindness in anesthesiology: A simulation study

STUDY OBJECTIVES

Inattentional blindness is the psychological phenomenon of inability to see the unexpected even if it is in plain view. We hypothesized that anesthesiologists may overlook unexpected intraoperative events whereas medical students, lacking in intraoperative monitoring experience and knowledge, may be more likely to notice such events.

DESIGN

A simulation study using a video of a simulated septic patient undergoing abdominal surgery.

SETTING

A large academic center.

PARTICIPANTS

31 certified anesthesiologists and 46 upper-year medical students.

INTERVENTIONS

None. Participants watched a video of a simulated surgery and scored the abnormalities they saw.

MEASUREMENTS

These abnormalities included abnormal physiologic parameters consistent with the condition of the simulated septic patient, and two unexpected but plausible events: head movement and a leaky central line catheter.

MAIN RESULTS

Students were significantly more likely than anesthesiologists to notice head movement (p<0.001).

What to do when an endotracheal tube cuff leaks

The authors describe an approach and a novel technique to solve a leaky endotracheal tube cuff problem in ventilator-dependent patients without immediately resorting to the potentially hazardous task of changing an endotracheal tube.