1989 INTRA-OPERATIVE ASSESSMENT OF MICROSURGICAL SKILL USING HAND MOTION ANALYSIS ESTABLISHING LEARNING CURVES OF SURGICAL COMPETENCE DURING VASECTOMY REVERSAL

Abstract

You have accessJournal of UrologyInfertility: Therapy1 Apr 20121989 INTRA-OPERATIVE ASSESSMENT OF MICROSURGICAL SKILL USING HAND MOTION ANALYSIS ESTABLISHING LEARNING CURVES OF SURGICAL COMPETENCE DURING VASECTOMY REVERSAL Ethan Grober, Majid Fanipour, Matthew Roberts, and Uma Victor Ethan GroberEthan Grober Toronto, Canada More articles by this author , Majid FanipourMajid Fanipour Toronto, Canada More articles by this author , Matthew RobertsMatthew Roberts Ottawa, Canada More articles by this author , and Uma VictorUma Victor Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2150AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Within urology and other surgical disciplines, intra-operative assessment of technical skill remains largely unvalidated and subjective. In the training laboratory, measures of economy of hand motion have demonstrated promise as reliable, valid and objective measures of technical competence. The primary objective of the current study was to validate live, intra-operative assessments of economy of hand motion as an objective measure of microsurgical skill and to use hand-motion analysis to establish competency-based surgical learning curves. METHODS Economy of hand-motion (number of hand movements and hand travel distance) was serially evaluated on a standardized, live-patient, intra-operative microsurgical suturing task (microsurgical vasovasostomy). Urology residents, clinical fellows and experienced microsurgeon were simultaneously evaluated. Hand-motion analyses were correlated with blinded, case-matched assessments of technical skill using previously validated global rating scales and task-specific checklists applied to unedited surgical videos. Serial hand-motion data from the urology residents, clinical fellows and experienced surgeons acquired over 19 consecutive cases were compared and used to establish competency-based learning curves over time. RESULTS 12 urology residents, 4 fellows and 3 faculty were evaluated. Intra-operative measures of economy of hand-motion correlated significantly with case-matched checklist scores and global ratings of surgical performance (r > 0.75, p < 0.001). Total number of hand movements, hand travel distance and operating time improved significantly over time for the urology residents (p=0.03) and fellows (p=0.02) but remained stable for the experienced surgeons (p=0.5). Meaningful learning curves can be generated to establish competency standards and provide feedback to surgical trainees over time (Figure 1 - Total Hand Movements). CONCLUSIONS Hand motion analysis represents a feasible, objective and valid measure of microsurgical skill while operating on real patients and can be used to establish competency-based surgical learning curves over time. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e802-e803 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ethan Grober Toronto, Canada More articles by this author Majid Fanipour Toronto, Canada More articles by this author Matthew Roberts Ottawa, Canada More articles by this author Uma Victor Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...