New model for skills assessment and training progress in minimally invasive surgery

BackgroundWith the spread of minimally invasive surgery and training in this field, development of metrics for skills assessment and training progress has become increasingly important. Our approach was to use the tracking of motion for the definition of objectives metrics.MethodsWe have developed an inanimate model and tracked the 3D coordinates of the instrument tips with an ultrasound system. Besides already validated parameters (time, error time, and distance efficiency ratio) we examined the transit and the speed profile for their evidentiary power. Performances of experts (who have already performed >100 laparoscopic operations) and novices (<20 laparoscopic operations) were evaluated.ResultThe standardized time, the error time as a precision indicator, and the transit profile parameter for spatial perception could significantly (p < 0.05) distinguish between experts and novices. Furthermore, these parameters and the distance efficiency ratio improved significantly during a training course in laparoscopic surgery.ConclusionOur model showed changes of the mentioned parameters with experience. According to our results, it can be used for skills assessment and as a training progress measurement system. We propose transit profile as an additional important parameter for assessment.

[1]  J. Rosser,et al.  Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. , 1998, Archives of surgery.

[2]  A. Gallagher,et al.  Experienced laparoscopic surgeons are automated to the "fulcrum effect": an ergonomic demonstration. , 1999, Endoscopy.

[3]  A. Darzi,et al.  Assessing operative skill , 1999, BMJ.

[4]  R. M. Satava,et al.  The need for metrics in surgical education , 1999, Surgical Endoscopy.

[5]  Z Dvir,et al.  Reproducibility and instrument validity of a new ultrasonography-based system for measuring cervical spine kinematics. , 2000, Clinical biomechanics.

[6]  J. R Browne,et al.  Validating simulation and assessment devices in surgery: A review , 2000 .

[7]  Harrith M. Hasson,et al.  Training Simulator for Developing Laparoscopic Skills , 2001, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[8]  A. Darzi,et al.  The role of the Basic Surgical Skills course in the acquisition and retention of laparoscopic skill , 2001, Surgical Endoscopy.

[9]  C D Smith,et al.  Assessing laparoscopic manipulative skills. , 2001, American journal of surgery.

[10]  Alfred Cuschieri,et al.  The performance of master surgeons on the Advanced Dundee Endoscopic Psychomotor Tester: contrast validity study. , 2002, Archives of surgery.

[11]  Ara Darzi,et al.  Electromagnetic motion analysis in the assessment of surgical skill: Relationship between time and movement , 2002, ANZ journal of surgery.

[12]  R. Reznick,et al.  Teaching the surgical craft: From selection to certification. , 2002, Current problems in surgery.