Surgeons' physiological parameters and surgical performance: a systematic scoping review.

Abstract

BACKGROUND: Wearable sensors enable objective, non-invasive and accurate measurement of surgeons’ physiological parameters that potentially impact surgeon performance and patient outcomes. This scoping review aimed to explore studies measuring surgeons’ sleep, stress or physical activity using wearable sensors and to identify research gaps. METHODS: A systematic search of PubMed and Scopus was conducted following PRISMA-ScR guidelines, for English-language articles published from January 1, 1950 to June 1, 2025. We included original quantitative studies measuring sleep, stress or physical activity in practicing or training surgeons, either as a parameter to investigate, or a determinant of performance. Data on physiological parameters, surgeon and surgical procedure, operating room (OR) setting, performance, study design, objectives, and findings were extracted using a predefined form. RESULTS: Among 100 included studies, 88 measured stress, 9 sleep, and 5 physical activity. Stress was primarily assessed intraoperatively while sleep and physical activity during extended period inside/outside the OR. Most studies investigated the relationship between physiological parameters and surgeon attributes or within team role (43%), patient or surgical procedure (32%), OR setting, specific changes, or methods (17%). Six studies (6%) examined stress-performance links, with conflicting findings. Three studies (3%) suggested poor sleep may increase medical error risk, with inconsistent conclusions on burnout. Only one study quantified the influence of these parameters on patient outcomes. CONCLUSION: Tangible evidence linking surgeons’ physiological parameters and performance in the OR remains limited. Available sensor technologies nowadays represent emerging opportunities to close this gap and improve understanding of how surgeon-related human factors impact patient safety.