Surgical Skill Assessment Using Motion Qyality and Smoothness
Surgical Skill Assessment Using Motion Qyality and Smoothness
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DOI：
10.1016/j.jsurg.2016.10.006
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发表时间：
2017-03-01
影响因子：
2.9
通讯作者：
Sutherland, Garnette R.
中科院分区：
文献类型：
--
作者：
Ghasemloonia, Ahmad;Maddahi, Yaser;Sutherland, Garnette R.
目的：本文介绍了一种定量技术，用于评估外科手术中常见的微操作任务执行过程中的运动质量和平稳性。目的是研究作为评估手术效果的动静测量指标--加速度对时间的导数--的有效性。设计：一种外科手术钳配备了位置跟踪器和加速度计，可以测量相对于工具运动的位置和加速度。参与者被要求在改良的O‘Connor灵巧板和镊子灵巧板(放置在头骨内)上执行钉在洞中的任务。研究对象：四组参与者(外科医生、外科住院医生、工程师和医生)参加了测试。结果：结果显示，外科医生在所有任务中表现出更好的挺举指数表现。此外，与工程师和游戏玩家相比，住院医生体验到的运动更接近外科医生。单因素方差分析显示，在所有任务的执行过程中，4组间的归一化挺举指数平均值之间存在显著差异。结论：归一化痉挛指数作为一个独立的时间和幅度参数，是衡量手部运动平顺性的一个指标，可以用来评价外科医生的手部运动灵活性。此外，该方法为学员评估和熟练程度提供了可量化的指标，特别是在外科培训转向基于能力的范例时。(C)2017年外科项目主任协会。爱思唯尔公司出版，版权所有。
OBJECTIVES: This article presents a quantitative technique to assess motion quality and smoothness during the performance of micromanipulation tasks common to surgical maneuvers. The objective is to investigate the effectiveness of the jerk index, a derivative of acceleration with respect to time, as a kinetostatic measure for assessment of surgical performance.DESIGN: A surgical forceps was instrumented with a position tracker and accelerometer that allowed measurement of position and acceleration relative to tool motion. Participants were asked to perform peg-in-hole tasks on a modified O'Connor Dexterity board and a Tweezer Dexterity pegboard (placed inside a skull). Normalized jerk index was calculated for each individual task to compare smoothness of each group.SETTING: This study was conducted at Project neuroArm, Cumming School of Medicine, the University of Calgary.PARTICIPANTS: Four groups of participants (surgeons, surgery residents, engineers, and garners) participated in the tests.RESULTS: Results showed that the surgeons exhibited better jerk index performance in all tasks. Moreover, the residents experienced motions closer to the surgeons compared to the engineers and gamers. One-way analysis of variance test indicated a significant difference between the mean values of normalized jerk indices among 4 groups during the performance of all tasks. Moreover, the mean value of the normalized jerk index significantly varied for each group from one task to another.CONCLUSIONS: Normalized jerk index as an independent parameter with respect to time and amplitude is an indicator of motion smoothness and can be used to assess hand motion dexterity of surgeons. Furthermore, the method provides a quantifiable metrics for trainee assessment and proficiency, particularly relevant as surgical training shifts toward a competency-based paradigm. (C) 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.