Objective classification of residents based on their psychomotor laparoscopic skills
Objective classification of residents based on their psychomotor laparoscopic skills
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DOI：
10.1007/s00464-009-0721-y
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发表时间：
2010-05-01
影响因子：
3.1
通讯作者：
Dankelman, Jenny
中科院分区：
文献类型：
--
作者：
Chmarra, Magdalena K.;Klein, Stefan;Dankelman, Jenny
从临床的角度来看，重要的是要认识到居民的专业知识水平方面的基本心理技能。因此，外科医生和外科组织（例如，研究生医学教育认证理事会）正在呼吁评估工具，认证居民的技术能力。目前，没有一种方法被普遍接受或推荐用于根据他们的技术能力将住院医师分为“经验丰富”，“中间”或“新手”。本研究采用心理学腹腔镜技术对住院医师腹腔镜手术经验水平进行分类，其中10名经验丰富的住院医师（完成100例以上腹腔镜手术）、10名中级住院医师（完成10-100例腹腔镜手术）和11名新手（无经验）在训练箱中完成4项任务。使用TrEndo跟踪系统记录腹腔镜器械的运动，并使用6个运动分析参数（MAP）进行分析。所有参与者的地图提交给主成分分析（PCA），数据减少技术。第一主成分的得分用于进行线性判别分析（LDA），一种分类方法。LDA的性能进行了检查，使用留一交叉validation.Of 31名参与者，23被正确分类与所提出的方法，与7分类为有经验的，7个为中间，9个为novice.The所提出的方法提供了一种手段，居民客观地分为有经验的，中间，或新手外科医生根据他们的基本腹腔镜技能。由于引入的分类方法的简单性和通用性，它很容易在现有的训练器中实现。
From the clinical point of view, it is important to recognize residents' level of expertise with regard to basic psychomotor skills. For that reason, surgeons and surgical organizations (e.g., Acreditation Council for Graduate Medical Education, ACGME) are calling for assessment tools that credential residents as technically competent. Currently, no method is universally accepted or recommended for classifying residents as "experienced," "intermediates," or "novices" according to their technical abilities. This study introduces a classification method for recognizing residents' level of experience in laparoscopic surgery based on psychomotor laparoscopic skills alone.For this study, 10 experienced residents (> 100 laparoscopic procedures performed), 10 intermediates (10-100 procedures performed), and 11 novices (no experience) performed four tasks in a box trainer. The movements of the laparoscopic instruments were recorded with the TrEndo tracking system and analyzed using six motion analysis parameters (MAPs). The MAPs of all participants were submitted to principal component analysis (PCA), a data reduction technique. The scores of the first principal components were used to perform linear discriminant analysis (LDA), a classification method. Performance of the LDA was examined using a leave-one-out cross-validation.Of 31 participants, 23 were classified correctly with the proposed method, with 7 categorized as experienced, 7 as intermediates, and 9 as novices.The proposed method provides a means to classify residents objectively as experienced, intermediate, or novice surgeons according to their basic laparoscopic skills. Due to the simplicity and generalizability of the introduced classification method, it is easy to implement in existing trainers.