Drilling sounds are used by surgeons and intermediate residents, but not novice orthopedic trainees, to guide drilling motions.

BACKGROUND The purpose of our study was to investigate the impact of distracting noise on the performance on a simulated orthopedic bone drilling skill when that noise blocks routine auditory feedback associated with the sounds of the drill. METHODS Medical students (n=11), intermediate residents (postgraduate years 3-5, n=10) and surgeons (n=8) each drilled 20 bicortical holes in a femur bone from a lamb: 10 holes without and 10 holes with the presence of distracting noise. We quantified surgical outcome in the form of plunge depth using computer-assisted objective methods. RESULTS Novice participants plunged more than did the intermediate trainees and surgeons (p<0.001). With the addition of distracting noise, the plunges of both intermediate residents and surgeons were affected. CONCLUSION Distracting noise impairs orthopedic bone drilling performance, and the ability to use drilling sounds to guide drilling motions is part of surgical expertise.