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Objective assessment of colonoscope manipulation skills in colonoscopy training. | LitMetric

Objective assessment of colonoscope manipulation skills in colonoscopy training.

Int J Comput Assist Radiol Surg

Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, ON, Canada.

Published: January 2018

AI Article Synopsis

  • The study aims to create a simulated system that helps novice clinicians learn colonoscope manipulation skills by objectively assessing their technical proficiency before working with real patients.
  • A motion tracking setup was implemented to analyze wrist and elbow joint movements during colonoscopies and successfully differentiate the performance levels of novice and expert operators in a controlled environment.
  • Results showed that novices had longer times and more hand movements compared to experts, while experts demonstrated more advanced joint motions, indicating that the developed system can effectively evaluate and improve technical skills in a training context.

Article Abstract

Objective: Manipulation of the colonoscope is a technical challenge for novice clinicians which is best learned in a simulated environment. It involves the coordination of scope tip steering with scope insertion, using a rotated image as reference. The purpose of this work is to develop and validate a system which objectively assesses colonoscopy technical skills proficiency in an arbitrary training environment, allowing novices to assess their technical proficiency prior to real patient encounters.

Methods: We implemented a motion tracking setup to objectively analyze and assess the way operators perform colonoscopies, including an analysis of wrist and elbow joint motions. Subsequently, we conducted a validation study to verify whether our motion analysis could discriminate novice colonoscopists from experts. Participants navigated a wooden bench-top model using a standard colonoscope while their motions were tracked.

Results: The developed motion tracking setup allowed colonoscopists of varying levels of proficiency to have their colonoscope manipulation assessed, and was able to be operated by a trained non-technical operator. Novice operators had significantly greater median times (101.5 vs. 31.5 s) and number of hand movements (62.0 vs. 21.5) than experts. Experts, however, spent a significantly greater proportion of time in extreme ranges of wrist and elbow joint motion than novices.

Conclusion: We have developed and implemented a hand and joint motion analysis system that is able to discriminate novices from experts based on objective measures of motion. These metrics could, thus, serve as proxies for technical proficiency during training.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11548-017-1676-4DOI Listing

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