The Dimensionless Squared Jerk: An Objective Parameter That Improves Assessment of Hand Motion Analysis during Simulated Shoulder Arthroscopy.

Erica Kholinne,Arnold Adikrishna,Jaesung Hong,Hanpyo Hong,Maulik J Gandhi,In-Ho Jeon,Haewon Kim

doi:10.1155/2018/7816160

Abstract

Purpose Attempts to quantify hand movements of surgeons during arthroscopic surgery faced limited progress beyond motion analysis of hands and/or instruments. Surrogate markers such as procedure time have been used. The dimensionless squared jerk (DSJ) is a measure of deliberate hand movements. This study tests the ability of DSJ to differentiate novice and expert surgeons (construct validity) whilst performing simulated arthroscopic shoulder surgical tasks. Methods Six residents (novice group) and six consultants (expert group) participated in this study. Participants performed three validated tasks sequentially under the same experimental setup (one performance). Each participant had ten performances assessed. Hand movements were recorded with optical tracking system. The DSJ, time taken, total path length, multiple measures of acceleration, and number of movements were recorded. Results There were significant differences between novices and experts when assessed using time, number of movements with average and minimal acceleration threshold, and DSJ. No significant differences were observed in maximum acceleration, total path length, and number of movements with 10m/s2 acceleration threshold. Conclusion DSJ is an objective parameter that can differentiate novice and expert surgeons' simulated arthroscopic performances. We propose DSJ as an adjunct to more conventional parameters for arthroscopic surgery skills assessment.

Highlights

There is currently no accepted definition of arthroscopic skills competency or proficiency [1]
No significant difference was observed in number of movements (10 m/s2) (p = 0.371), maximum acceleration (p = 0.545), or total path length (p = 0.395) (Table 1)
Consultants were significantly quicker to complete all tasks and had a faster average and range of acceleration. They had a highly significant lower dimensionless squared jerk (DSJ) indicating that consultants had less unwanted and more purposeful movements than novices

Summary

Introduction

There is currently no accepted definition of arthroscopic skills competency or proficiency [1]. This makes it difficult for training institutions to set skills assessments for competencybased training [2, 3]. These assessments can be categorized as being subjective, objective, or assumption of competence by numbers. Subjective assessment is the simplest and earliest form of assessment. It has been shown that this form of assessment does not reflect the actual level of skill the trainee may possess [2, 5]

Methods

Results

Conclusion