SutureCoach: Examining Vascular Suturing Skills Assessment, Training, and Transfer of Training via Objective Metrics

SutureCoach：通过客观指标检查血管缝合技能评估、培训和培训转移

• 批准号: 10242761
• 负责人: Ravikiran Singapogu
• 金额: $ 37.35万
• 依托单位: CLEMSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-05 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10242761
• 关键词: Anastomosis - action; Arteriovenous fistula; Benchmarking; Blood Vessels; Cadaver; Cause of Death; Clinical; Collaborations; Communities; Community Health Education; Credentialing; Data; Data Set; Education; Educational Curriculum; Event; Exercise; Feedback; Goals; Hand; Hemostatic Techniques; Image; Laparoscopy; Learning Skill; Ligation; Measures; Medical Errors; Methods; Modality; Modeling; Motion; Movement; Needles; Operating Rooms; Operative Surgical Procedures; Outcome; Outcome Measure; Patient-Focused Outcomes; Performance; Phase; Procedures; Process; Psychological Transfer; Puncture procedure; Radial; Randomized; Reporting; Research; Side; Standardization; Surgeon; Surgical sutures; Task Performances; Technical Expertise; Techniques; Testing; Time; Training; Validation; Vision; base; design; experimental study; force sensor; improved; instrument; large datasets; medical complication; motion sensor; multimodality; next generation; novel strategies; patient safety; programs; response; simulation; skills; skills training; tool

Project Summary The skill of a surgeon is critical to successful patient outcomes. A recent landmark study reported that surgeons' skill ratings were significantly correlated with clinical outcomes after surgery. A number of studies have documented medical errors that led to potential medical complications caused by unskilled surgical maneuvers. One way to reduce medical errors, now the third leading cause of death in the US, is to focus on effective and efficient methods to train surgical skills of clinicians. To respond to the challenges being faced with training the next generation of vascular surgeons, the Vascular Surgery Board along with other vascular surgery educators have developed a set of core skills for open vascular surgery called the Fundamentals of Vascular Surgery(FVS) consisting of five skills—knot tying, radial suturing, anastomosis (end-to-end, end-to-side), ligation and hemostatic techniques—performed on bench models with synthetic materials towards measuring resident performance. These set of exercises are modeled after the Fundamentals of Laparoscopic Skills curriculum, used for credentialing general surgeons who perform laparoscopy. There are several limitations of the FVS curriculum, however: rudimentary outcome metrics, lack of robust feedback for skills training and correlating simulator and Operating Room (OR) performance. Over the past several years, our team has collaborated with the creators of the Fundamentals of Vascular Surgery curriculum to create an instrumented simulator that measures vascular suturing skill. Metrics on our simulator platform measure key aspects of skilled vascular suturing: needle movement, tear forces, needle driver motion and hand movement. These metrics provide a rich set of event-specific, multi-modal and real-time metrics for assessment of vascular suturing. Initial validation demonstrates that the simulator metrics can differentiate between resident and attending suturing skill including suturing in a simulated cavity (at depth). The goal of this project is to provide the vascular surgery community with training tools that quantify skilled performance on vascular suturing, accelerate training and correlate metrics for transfer of training to the OR. Our three project aims are: Aim 1: Test the hypothesis that metrics for vascular suturing skill on the simulator differentiate between expert and novice skill level on a large data set; Aim 2: Test the hypothesis that vascular suturing training on the simulator with metrics-based feedback will improve skill on the simulator; Aim 3: Test the hypothesis that (1) training on simulator transfers to the FVS anastomosis task and (2) task performance on the simulator is correlated with intraoperative performance. 1

项目摘要 外科医生的技能对成功的患者结局至关重要。最近一项具有里程碑意义的研究报告称， 技能等级与术后临床结果显著相关。多项研究 记录的医疗错误导致不熟练的手术操作引起的潜在医疗并发症。 减少医疗差错的一种方法，现在是美国第三大死亡原因，是把重点放在有效和 培养临床医生手术技能的有效方法。 为了应对培养下一代血管外科医生所面临的挑战， 血管外科委员会沿着与其他血管外科教育工作者一起开发了一套开放式手术的核心技能。 血管外科称为血管外科基础（FVS），包括五种技能-打结、径向 吻合、吻合（端对端、端对侧）、结扎和止血技术-在工作台上进行 用合成材料制作的模型来衡量居民的表现。这套练习是仿照 在腹腔镜技能基础课程之后，用于授予执行以下操作的普通外科医生资格： 腹腔镜检查然而，FVS课程有几个局限性：基本的结果指标，缺乏 用于技能培训以及相关模拟器和手术室（OR）性能的强大反馈。 在过去的几年里，我们的团队与《血管基础》的创作者合作， 手术课程，以创建测量血管扩张技能的仪器模拟器。关于我们 模拟器平台测量熟练血管造影术关键方面：针移动、撕裂力、针驱动器 运动和手部运动。这些指标提供了一组丰富的特定于事件、多模态和实时的指标 用于评估血管痉挛。初步验证表明，模拟器指标可以区分 住院医师和主治医师之间的沟通技能，包括在模拟腔中的沟通（深度）。 该项目的目标是为血管外科社区提供培训工具， 血管造影的性能，加速训练和相关指标，以将训练转移到OR。我们 三个项目目标是：目标1：在模拟器上测试血管造影技能的指标 在大数据集上区分专家和新手技能水平;目的2：检验血管 在模拟器上使用基于度量的反馈进行模拟训练将提高模拟器上的技能;目标3：测试 假设（1）模拟器上的培训转移到FVS吻合任务，（2） 模拟器与术中性能相关。 1