OBJECTIVE MEASUREMENT FOR SURGICAL SKILL EVALUATION
DOI:
https://doi.org/10.11113/jt.v78.9461Keywords:
Psychomotor skills, assessment parameters, computer based measurementsAbstract
The purpose of this study was to identify measurable parameters that can be used to quantitatively assess psychomotor skills, specifically for surgical skills assessment. Sixteen participants were recruited from two groups: surgeon (N = 5) and non-surgeon (N = 11). Both groups underwent a psychomotor test using a custom developed ‘Green Target’ module which was designed using a virtual reality system. Six parameters were used to compare the psychomotor skills between the two groups. The results showed that surgeons outperformed the non-surgeons in five out of six parameters investigated and the difference was statistically significant. The average normalised comparison values for surgeons and non-surgeons for motion path accuracy, motion path precision, economy of movement, end-point accuracy and end-point precision were 0.13+0.12 and 0.17+0.12, 0.08+0.11 and 0.10+0.10, 3.76+1.76 and 4.08+2.24, 0.12+0.10 and 0.17+0.11, 0.04+0.10 and 0.07+0.10 respectively, p < 0.05). These parameters can potentially be used to objectively assess the performance of surgical skill. Â
References
Lossing, A. G., Hatswell, E. M., Gilas, T., Reznick, R. K. and Smith, L. C. 1992. A Technical-Skills Course for 1st-Year Residents in General Surgery: Residents in General Surgery: A Descriptive Study. Canadian Journal of Surgery. 35(5): 536-540.
Rodriguez-Paz, J. M., Kennedy, M., Salas, E., Wu, A. W., Sexton, J. B., Hunt, E. A. and Pronovost, P. J. 2009. Beyond ‘See One, Do One, Teach One’: Toward a Different Training Paradigm. Postgraduate Medical Journal. 85(1003): 244-249.
Bridges, M. and Diamond, D. L.1999. The Financial Impact of Teaching Surgical Residents in the Operating Room. American Journal of Surgery. 177(1): 28-32.
Babineau, T. J., Becker, J., Gibbons, G., Sentovic, S., Hess, D., Robertson, S. and Stone, M. 2004. The ‘Cost’ of Operative Training for Surgical Residents. Archives of Surgery. 139(4): 366-369.
Moorthy, K., Munz, Y., Adams, S., Pandey, V. and Darzi, A. 2005. A Human Factors Analysis of Technical and Team Skills Among Surgical Trainees During Procedural Simulations in a Simulated Operating Theatre. Annals of Surgery. 242(5): 631-639.
Galasko, C. and Mackay, C. 1997. Unsupervised Surgical Training. Logbooks Are Essential for Assessing Progress. British Medical Journal. 315(7118): 1306-1307.
Begg, C. B., Cramer, L. D., Hoskins, W. J. and Brennan, M. F. 1998. Impact of Hospital Volume on Operative Mortality for Major Cancer Surgery. Journal of the American Medical Association. 280(20): 1747-1751.
Bridgewater, B., Grayson, A. D., Jackson, M., Brooks, N., Grotte, G. J., Keenan, D. J. M., Millner, R., Fabri, B. M. and Jones, M. 2003. Surgeon Specific Mortality in Adult Cardiac Surgery: Comparison Between Crude and Risk Stratified Data. British Medical Journal. 327(7405): 13-17.
Turrentine, F. E., Wang, H., Simpson, V. B. and Jones, R. S. 2006. Surgical Risk Factors, Morbidity, and Mortality in Elderly Patients. Journal of the American College of Surgeons. 203(6): 865-877.
Doyle, J. D., Webber, E. M. and Sidhu, R. S. 2007. A Universal Global Rating Scale for the Evaluation of Technical Skills in the Operating Room. American Journal of Surgery. 193(5): 551-555.
Chan, W., Niranjan, N. and Ramakrishnan, V. 2010. Structured Assessment of Microsurgery Skills in the Clinical Setting. Journal of Plastic, Reconstructive & Aesthetic Surgery. 63(8): 1329-1334.
Kalu, P. U., Atkins, J., Baker, D., Green, C. J. and Butler, P. E. M. 2005. How Do We Assess Microsurgical Skill?. Microsurgery. 25(1): 25-29.
Bann, S., Davis, I. M., Moorthy, k., Munz, Y., Hernandez, J., Khan, M., Datta, V. and Darzi, A. 2005. The Reliability of Multiple Objective Measures of Surgery and the Role of Human Performance. American Journal of Surgery. 189(6): 747-52.
Goff, B. A., Lentz, G. M., Lee, D., Fenner, D., Morris, J. and Mandel, L. S. 2001. Development of A Bench Station Objective Structured Assessment of Technical Skills. Obstetrics and Gynecology. 98(3): 412-416.
Wanzel, K. R., Matsumoto, E. D., Hamstra, S. J. and Anastakis, D. J. 2002. Teaching Technical Skills: Training on a Simple, Inexpensive, and Portable Model. Journal of Plastic, Reconstructive & Aesthetic Surgery. 109(1): 258-263.
Grober, E. D., Hamstra, S. J., Wanzel, K. R., Reznick, R. K. and Matsumoto, E. D. 2003. Validation of Novel and Objective Measures of Microsurgical Skill: Hand-Motion Analysis and Stereoscopic Visual Acuity. Microsurgery. 23(4): 317-322.
Bann, S. D., Khan, M. S. and Darzi, A. W. 2003. Measurement of Surgical Dexterity Using Motion Analysis of Simple Bench Tasks. World Journal of Surgery. 27(4): 390-394.
Blyth, P., Stott, N. S. and Anderson, I. A. 2008. Virtual Reality Assessment of Technical Skill Using the Bonedoc DHS Simulator. Injury, International Journal of the Care of The Injured. 39(10): 1127-1133.
Then, T. F., Su, E. L. M., Ahmmad, S. N. Z. and Yeong, C. F. 2013. Massed Training Versus Interval Training for Computer-Based Suturing Skill Acquisition. Journal of Medical Imaging and Health Informatics. 3(4): 503-508.
Ahmmad, S. N. Z., Su, E. L. M. and Yeong, C. F. 2013. Effect of Intermittent Haptic Disturbance in Motor Skill Training. Applied Mechanics and Materials. 432: 403-408.
Pellen, M. G. C., Horgan, L. F., Barton, J. R. and Attwood, S. E. 2009. Construct Validity of the Promis Laparoscopic Simulator. Surgical Endoscopy. 23(1): 130-139.
Ahmmad, S. N. Z., Chew, Z. S., Su, E. L. M. and Yeong, C. F. 2015. Force Variability as an Objective Measure of Surgical Skill. Jurnal Teknologi. 74(6): 125-128.
Ahmmad, S. N. Z., Su, E. L. M., Yeong, C. F. and Narayanan, A. L. T. 2014. Experimental Study of Surgeon’s Psychomotor Skill Using Sensor-Based Measurement. Procedia Computer Science. 42: 130-137.
Su, E.L.M., Ganesh, G., Yeong, C. F. and Burdet, E. 2010. Accurate Micromanipulation Induced by Performing in Unstable Dynamics. 19th IEEE International Symposium on Robot and Human Interactive Communication. 762-766.
Harwell, R. C. & Ferguson, R. L. 1983. Physiologic Tremor and Microsurgery. Microsurgery. 4(3): 187-192.
Rooks, M. D., Slappey, J. and Zusmanis, K. 1993. Precision of Suture Placement With Microscope- And Loupe-Assisted Anastomoses. Microsurgery. 14(8): 547-550.
Risucci, D. A. 2002. Visual Spatial Perception and Surgical Competence. American Journal of surgery. 184(3): 291-295.
Elble, R. J. 2003. Characteristics of Physiologic Tremor in Young and Elderly Adults. Journal of Clinical Neurophysiology. 114(4): 624-635.
Elble, R. J. 1996. Central Mechanisms of Tremor. Journal of Clinical Neurophysiology. 13(2): 133-144.
Sturman, M. M., Vaillancourt, D. E. and Corcos, D. M. 2005. Effects of Aging on The Regularity of Physiological Tremor. Journal of Neurophysiology. 93(6): 3064-3074.
Hofstad, E. F., Vapenstad, C., Chmarra, M. K., Lango, T., Kuhry, E. and Marvik, R. 2012. A Study of Psychomotor Skills in Minimally Invasive Surgery: What Differentiates Expert and Nonexpert Performance. Surgical Endoscopy. 27(3): 854-863.
Chmarra, M. K., Kolkman, W., Jansen, F. W., Grimbergen, C. A. and Dankelman, J. 2007. The Influence of Experience and Camera Holding on Laparoscopic Instrument Movements Measured With the Trendo Tracking System. Surgical Endoscopy. 21(11): 2069-2075.
Maithel, S. K., Villegas, L., Stylopoulos, N., Dawson, S. and Jones, D. B. 2005. Simulated Laparoscopy Using a Head-Mounted Display vs Traditional Video Monitor: An Assessment of Performance and Muscle Fatigue. Surgical Endoscopy. 19: 406-411.
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