Grants Funded

Abstract
Stress has been defined in a number of ways. Most definitions of stress converge around
disrupting a homeostatic balance, be it a psychological or physiological set point. For the
purpose of this grant proposal we will define stress as an increase in arousal relative to baseline
stress levels, which is the homeostatic set point. Physiological stress alters blood flow
distribution, skin conductance, breathing rate, breathing rate, breathing function, and body
movement, which can all be quantified and analyzed using a battery of tests that include novel
technology, such as an E4 wrist sensor and Zephyr bioharness. Surgical training provides an
excellent framework because it is challenging and there are substantial stakes for trainees.
Surgical residents are under an enormous amount of pressure to perform newly acquired skills
precisely and as quickly as possible. In this project, we will test a novel integrated suite of
sensing and computational methods to unobtrusively quantify stress in plastic surgery residents
learning microsurgical techniques. We will use these tools to quantify and compare baseline
stress levels and response to an acute stressor in experienced and inexperienced
reconstructive surgery trainees. In this case, the acute stressor will be a standardized novel
microsurgical task that residents must perform. This project will help us better understand the
stress response in humans. We will gain information on how medical residents respond to
learning new tasks early and late in their training and how stress affects performance. At a
broader level, the proposed project is expected to shed light on how different stress phenotypes
affect predisposition toward learning. We will use this information to develop methods to
decrease resident stress and to develop the most effective resident training possible in the
future.

Biography
Dr. Anthony Echo earned his BS in biology at the University of Nevada in Reno, Nevada where he later attended medical school. After earning his doctorate of medicine, Dr. Echo was a resident at Baylor College of Medicine in Houston, Texas where he studied integrated plastic surgery. He completed fellowship at Stanford University Medical Center in Palo Alto, California where he honed his microvascular and reconstructive surgery skills. At Washington University in St. Louis Dr. Echo further studied peripheral nerve surgery. After his training, Dr. Echo became an Assistant Professor at Houston Methodist Hospital in Houston, Texas where he divides his time among patient care, medical research, and the education of residents and medical students pursuing training in plastic surgery. His research interests are in resident education, microvascular reconstructive surgery, complex peripheral nerve injuries, surgical treatment of migraine headaches, and chronic pain. He routinely gives lectures at Houston Methodist Hospital. Dr. Echo has published over 20 manuscripts and continues to contribute to research and scientific literature on reconstructive surgery and microsurgery.