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Quantifying surgeon maneuevers across experience levels through marker-less hand motion kinematics of simulated surgical tasks. | LitMetric

Quantifying surgeon maneuevers across experience levels through marker-less hand motion kinematics of simulated surgical tasks.

Appl Ergon

Department of Industrial and Systems Engineering, 1550 Engineering Drive, University of Wisconsin-Madison, Madison, WI, 53706, USA; Department of Biomedical Engineering, 1415 Engineering Drive, University of Wisconsin-Madison, Madison, WI, 53706, USA. Electronic address:

Published: September 2020

AI Article Synopsis

  • - This study analyzes the suturing hand motions of clinicians with varying experience levels (medical students, residents, and attending surgeons) on different tissue types (foam, pig feet, porcine bowel) to identify patterns in efficiency as skill increases.
  • - Key findings show that as clinicians gain experience, the path length of their non-dominant hand during suturing tasks decreases significantly, indicating improved performance and energy conservation.
  • - The results suggest that early training results in faster dominant hand movements, while advanced practitioners focus on conserving energy and distributing work more efficiently between hands, highlighting the potential for video-based motion analysis in medical training.

Article Abstract

This paper compares clinician hand motion for common suturing tasks across a range of experience levels and tissue types. Medical students (32), residents (41), attending surgeons (10), and retirees (2) were recorded on digital video while suturing on one of: foam, pig feet, or porcine bowel. Depending on time in position, each medical student, resident, and attending participant was classified as junior or senior, yielding six experience categories. This work focuses on trends associated with increasing tenure observed from those medical students (10), residents (15), and attendings (10) who sutured on foam, and draws comparison across tissue types where pertinent. Utilizing custom software, the two-dimensional location of each of the participant's hands were automatically recorded in every video frame, producing a rich spatiotemporal feature set. While suturing on foam, increasing clinician experience was associated with conserved path length per cycle of the non-dominant hand, significantly reducing from junior medical students (mean = 73.63 cm, sd = 33.21 cm) to senior residents (mean = 46.16 cm, sd = 14.03 cm, p = 0.015), and again between senior residents and senior attendings (mean = 30.84 cm, sd = 14.51 cm, p = 0.045). Despite similar maneuver rates, attendings also accelerated less with their non-dominant hand (mean = 16.27 cm/s, sd = 81.12 cm/s, p = 0.002) than senior residents (mean = 24.84 cm/s, sd = 68.29 cm/s, p = 0.002). While tying, medical students moved their dominant hands slower (mean = 4.39 cm/s, sd = 1.73 cm/s, p = 0.033) than senior residents (mean = 6.53 cm/s, sd = 2.52 cm/s). These results suggest that increased psychomotor performance during early training manifest through faster dominant hand function, while later increases are characterized by conserving energy and efficiently distributing work between hands. Incorporating this scalable video-based motion analysis into regular formative assessment routines may enable greater quality and consistency of feedback throughout a surgical career.

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Source
http://dx.doi.org/10.1016/j.apergo.2020.103136DOI Listing

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