Thorac Cardiovasc Surg 2023; 71(08): 596-604
DOI: 10.1055/s-0043-1776407
Original Cardiovascular

Impact of a 36-hour Nonstop Training Course on Academic, Physical, and Mental Skills as well as Psychological Stress Perception in Cardiac Surgery Residents

Tulio Caldonazo*
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
Hristo Kirov*
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
Ulrich Schneider
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
Andreas Beckmann
2   Department for Cardiac and Pediatric Cardiac Surgery, Heart Center Duisburg, Duisburg, Germany
K. W.
3   Special Forces, Federal Police, Berlin, Germany
Günter Weber
4   Institute for Conflict Research and Crisis Consulting, Munich, Germany
Regina Iglauer-Sander
5   Press Office, German Society for Thoracic and Cardiovascular Surgery, Berlin, Germany
Gloria Färber
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
Torsten Doenst
1   Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
and on behalf of all Strong GermaN HeaRTS Participants › Author Affiliations
Funding The course was funded by the German Network for Heart Research and Trials in Surgery (GermaN HeaRTS, DFG funding to T.D., DO602/15-1) and by Abbott. T.C. was funded by the Deutsche Forschungsgemeinschaft (DFG) Clinician Scientist Program OrganAge (funding number 413668513), by the Deutsche Herzstiftung (DHS, German Heart Foundation; funding number S/03/23), and by the Interdisciplinary Center of Clinical Research of the Medical Faculty Jena.


Background Making the right decision in stressful situations is required for goal-oriented action in cardiac surgery. Current labor laws prevent residents to be subjected to situations that test their stress tolerance. These situations often occur only later in the career. We simulated such conditions in a structured non-stop 36-hour cardiac surgical training course and assessed the participant's performance.

Methods Fourteen advanced residents/junior staff surgeons were selected. The course was conducted in collaboration with the national antiterror police forces that provided coaching for teamplay, leadership, and responsibility awareness. The candidates attended graded and evaluated workshops/lectures and performed academic and surgical tasks. Psychological and surgical skill assessments were conducted at times 0, 12, 24, 36 hours.

Results Progressive reductions in individual motivation, associated with increased stress and irritability levels, worsening mood, and fatigue were observed. Long- and short-term memory functions were unaffected and practical surgical performance even increased over time.

Conclusion Among the candidates, 36 hours of sleep deprivation did not lead to relevant changes in the skills required from a cardiac surgeon in daily life. Importantly, group dynamics substantially improved during the course, suggesting advances in the perception of responsibility and teamwork.

Data Availability Statement

The data underlying this article will be kept digital and on file for the next 10 years.

* These authors contributed equally to this work.

Publication History

Received: 12 September 2023

Accepted: 12 October 2023

Article published online:
01 November 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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