Sharpening surgical skill : effects of alcohol and sleep deprivation on dexterity . Report to the Alcohol Education and Research Council

The training of surgeons has traditionally been an apprenticeship. Trainees learn to undertake surgical procedures by first observing, next assisting, then performing under supervision and finally performing alone. This is an efficient and safe method provided it is properly supervised, but there may be some skills that are better learnt in the training laboratory rather than in the operating theatre. The advent of minimal access or laparoscopic surgery has given particularly strong impetus to the development of new training and assessment methods. Minimal access surgery demands high dexterity and novel skills from the surgeon. Particularly important are the abilities to operate in a three-dimensional environment while observing a twodimensional image and to operate using very long tools, without the normal tactile feedback received when performing open surgery.