Abstract
Motion tracking software for assessing laparoscopic surgical proficiency has been proven to be effective in differentiating between expert and novice performances. However, with several indices that can be generated from the software, there is no set threshold that can be used to benchmark performances. The aim of this study was to identify the best possible algorithm that can be used to benchmark expert, intermediate and novice performances for objective evaluation of psychomotor skills. 12 video recordings of various surgeons were collected in a blinded fashion. Data from our previous study of 6 experts and 23 novices was also included in the analysis to determine thresholds for performance. Video recording were analyzed both by the Kinovea 0.8.15 software and a blinded expert observer using the CAT form. Multiple algorithms were tested to accurately identify expert and novice performances. ½ L + raisebox{1ex}{1}!left/ !raisebox{-1ex}{3}right. A + raisebox{1ex}{1}!left/ !raisebox{-1ex}{6}right. J scoring of path length, average movement and jerk index respectively resulted in identifying 23/24 performances. Comparing the algorithm to CAT assessment yielded in a linear regression coefficient R2 of 0.844. The value of motion tracking software in providing objective clinical evaluation and retrospective analysis is evident. Given the prospective use of this tool the algorithm developed in this study proves to be effective in benchmarking performances for psychomotor skills evaluation.
Highlights
Training and assessment in laparoscopic surgery are increasingly moving towards more objective and criterion-based evaluation tools. [1,2,3] Box trainers with cameras, virtual and augmented reality simulators have facilitated in achieving objective evaluation of technical skills. [4,5,6,7] Recent trends in
Nijmegen, the Netherlands surgical training, such as self-directed learning and reflective practice, indicate a positive effect of repetitive and independent practice, which have been made possible with objective evaluation tools. [8,9,10] Several objective criteria such as instrument movement, procedure time, and procedure specific risky maneuvers can be extracted from these simulators and serve as benchmarks for assessing the performance or selfassessment for progress monitoring. [11, 12] the use of these objective criteria in the operating room to assess real surgical procedures is currently limited
This has been achieved using specialized instruments using motion trackers and cameras. [13,14,15,16] We have previously used a motion tracking software which is independent of specialized equipment and instruments during the procedure and can be used for retrospective performance analysis using the video recording of the procedure
Summary
[11, 12] the use of these objective criteria in the operating room to assess real surgical procedures is currently limited It has been proven by Yamaguchi et al that motion tracking of the surgical instruments can objectively differentiate between expert and novice surgeons in a skills lab setting. This has been achieved using specialized instruments using motion trackers and cameras. J Med Syst (2020) 44: 56 movements’ and ‘average movements’, which could be extracted from the recorded videos classify expert and novice performances These indices, were procedure specific and as such required a set of benchmarks to assess individual procedures. The aim of this study is to develop a new set of benchmarks for psychomotor skills that scale between novice and expert performance and can be used in automated assessment tools
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