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Effet du stress sur la performance en chirurgie orthopédique : du modèle d'activité opératoire au modèle psycho-social

Abstract : Future orthopedic surgeons learn their craft on the mode of companionship by participating in proportion to their skills, some operative procedures. This learning takes place in a stressful workplace. Previous works have studied the effect of stress on the professional practice of expert and novice surgeons, but most of them did not use an experimental method and considered only the performance as a result of action. However, we believe that it is essential to take into account the strategies used (processing efficiency) and the result of action in order to properly understand the effects of stress on performance and the moderating role of expertise and task difficulty. Thus, this thesis has aimed to determine the effects of stress on performance for future orthopedic surgeons, and taking into account the efficiency of processing and performance. The first part of this work aimed at disentangling efficiency and output in the concept of performance. To do so, we conducted an analysis of the activity (Study 1). Results of this analysis allowed us to experimentally test the effects of stress on performance and efficiency. On the hole, the results show that stress impairs performance and efficiency for future orthopedic surgeons in a task of reading and interpretation of radiographs (Study 2) and in in a surgical simulation task (Study 3). In line with these findings, we developed a simulator for training future surgeons to enhance their training. Then, we proposed that the teaching of stress management should be integrated into the training of interns. To do so, we have focused our research on emotion regulation skills by testing the applicability of a technique to the field of stress (Study 4). The work done in this thesis is structured around several disciplines, and complementarity of these approaches has allowed us to make an important contribution to understanding and managing the effects of stress on medical performance.
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Emmanuelle Ceaux. Effet du stress sur la performance en chirurgie orthopédique : du modèle d'activité opératoire au modèle psycho-social. Psychologie. Université de Grenoble, 2013. Français. ⟨NNT : 2013GRENH042⟩. ⟨tel-01923386⟩

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