An Evaluation of the Feasibility, Validity, and Reliability of Laparoscopic Skills Assessment in the Operating Room
To assess the use of a synchronized video-based motion tracking device for objective, instant, and automated assessment of laparoscopic skill in the operating room. The assessment of technical skills is fundamental to recognition of proficient surgical practice. It is necessary to demonstrate the va...
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Published in | Annals of surgery Vol. 245; no. 6; pp. 992 - 999 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Hagerstown, MD
Lippincott
01.06.2007
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Subjects | |
Online Access | Get full text |
ISSN | 0003-4932 1528-1140 1528-1140 |
DOI | 10.1097/01.sla.0000262780.17950.e5 |
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Abstract | To assess the use of a synchronized video-based motion tracking device for objective, instant, and automated assessment of laparoscopic skill in the operating room.
The assessment of technical skills is fundamental to recognition of proficient surgical practice. It is necessary to demonstrate the validity, reliability, and feasibility of any tool to be applied for objective measurement of performance.
Nineteen subjects, divided into 13 experienced (performed >100 laparoscopic cholecystectomies) and 6 inexperienced (performed <10 LCs) surgeons completed LCs on 53 patients who all had a diagnosis of biliary colic. Each procedure was recorded with the ROVIMAS video-based motion tracking device to provide an objective measure of the surgeon's dexterity. Each video was also rated by 2 experienced observers on a previously validated operative assessment scale.
There were significant differences for motion tracking parameters between the 2 groups of surgeons for the Calot triangle dissection part of procedure for time taken (P = 0.002), total path length (P = 0.026), and number of movements (P = 0.005). Both motion tracking and video-based assessment displayed intertest reliability, and there were good correlations between the 2 modes of assessment (r = 0.4 to 0.7, P < 0.01).
An instant, objective, valid, and reliable mode of assessment of laparoscopic performance in the operating room has been defined. This may serve to reduce the time taken for technical skills assessment, and subsequently lead to accurate and efficient audit and credentialing of surgeons for independent practice. |
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AbstractList | The assessment of technical skills in the operating room is fundamental to the credentialing of surgeons for independent practice. This paper investigates the use of motion-tracking of a surgeon's hands for assessment of laparoscopic skill, in synchrony with video-based assessment of performance on a structured rating scale. To assess the use of a synchronized video-based motion tracking device for objective, instant, and automated assessment of laparoscopic skill in the operating room.OBJECTIVETo assess the use of a synchronized video-based motion tracking device for objective, instant, and automated assessment of laparoscopic skill in the operating room.The assessment of technical skills is fundamental to recognition of proficient surgical practice. It is necessary to demonstrate the validity, reliability, and feasibility of any tool to be applied for objective measurement of performance.SUMMARY BACKGROUND DATAThe assessment of technical skills is fundamental to recognition of proficient surgical practice. It is necessary to demonstrate the validity, reliability, and feasibility of any tool to be applied for objective measurement of performance.Nineteen subjects, divided into 13 experienced (performed >100 laparoscopic cholecystectomies) and 6 inexperienced (performed <10 LCs) surgeons completed LCs on 53 patients who all had a diagnosis of biliary colic. Each procedure was recorded with the ROVIMAS video-based motion tracking device to provide an objective measure of the surgeon's dexterity. Each video was also rated by 2 experienced observers on a previously validated operative assessment scale.METHODSNineteen subjects, divided into 13 experienced (performed >100 laparoscopic cholecystectomies) and 6 inexperienced (performed <10 LCs) surgeons completed LCs on 53 patients who all had a diagnosis of biliary colic. Each procedure was recorded with the ROVIMAS video-based motion tracking device to provide an objective measure of the surgeon's dexterity. Each video was also rated by 2 experienced observers on a previously validated operative assessment scale.There were significant differences for motion tracking parameters between the 2 groups of surgeons for the Calot triangle dissection part of procedure for time taken (P = 0.002), total path length (P = 0.026), and number of movements (P = 0.005). Both motion tracking and video-based assessment displayed intertest reliability, and there were good correlations between the 2 modes of assessment (r = 0.4 to 0.7, P < 0.01).RESULTSThere were significant differences for motion tracking parameters between the 2 groups of surgeons for the Calot triangle dissection part of procedure for time taken (P = 0.002), total path length (P = 0.026), and number of movements (P = 0.005). Both motion tracking and video-based assessment displayed intertest reliability, and there were good correlations between the 2 modes of assessment (r = 0.4 to 0.7, P < 0.01).An instant, objective, valid, and reliable mode of assessment of laparoscopic performance in the operating room has been defined. This may serve to reduce the time taken for technical skills assessment, and subsequently lead to accurate and efficient audit and credentialing of surgeons for independent practice.CONCLUSIONSAn instant, objective, valid, and reliable mode of assessment of laparoscopic performance in the operating room has been defined. This may serve to reduce the time taken for technical skills assessment, and subsequently lead to accurate and efficient audit and credentialing of surgeons for independent practice. To assess the use of a synchronized video-based motion tracking device for objective, instant, and automated assessment of laparoscopic skill in the operating room. The assessment of technical skills is fundamental to recognition of proficient surgical practice. It is necessary to demonstrate the validity, reliability, and feasibility of any tool to be applied for objective measurement of performance. Nineteen subjects, divided into 13 experienced (performed >100 laparoscopic cholecystectomies) and 6 inexperienced (performed <10 LCs) surgeons completed LCs on 53 patients who all had a diagnosis of biliary colic. Each procedure was recorded with the ROVIMAS video-based motion tracking device to provide an objective measure of the surgeon's dexterity. Each video was also rated by 2 experienced observers on a previously validated operative assessment scale. There were significant differences for motion tracking parameters between the 2 groups of surgeons for the Calot triangle dissection part of procedure for time taken (P = 0.002), total path length (P = 0.026), and number of movements (P = 0.005). Both motion tracking and video-based assessment displayed intertest reliability, and there were good correlations between the 2 modes of assessment (r = 0.4 to 0.7, P < 0.01). An instant, objective, valid, and reliable mode of assessment of laparoscopic performance in the operating room has been defined. This may serve to reduce the time taken for technical skills assessment, and subsequently lead to accurate and efficient audit and credentialing of surgeons for independent practice. |
Author | Moorthy, Krishna Papasavas, Pavlos Aggarwal, Rajesh Grantcharov, Teodor Dosis, Aristotelis Milland, Thor Bello, Fernando Darzi, Ara |
AuthorAffiliation | From the Department of Biosurgery & Surgical Technology, Imperial College London, UK; †Department of Surgical Gastroenterology, Glostrup University Hospital, Glostrup, Denmark; and ‡Department of Surgery, Western Pennsylvania Hospital, Pittsburgh, PA |
AuthorAffiliation_xml | – name: From the Department of Biosurgery & Surgical Technology, Imperial College London, UK; †Department of Surgical Gastroenterology, Glostrup University Hospital, Glostrup, Denmark; and ‡Department of Surgery, Western Pennsylvania Hospital, Pittsburgh, PA |
Author_xml | – sequence: 1 givenname: Rajesh surname: Aggarwal fullname: Aggarwal, Rajesh – sequence: 2 givenname: Teodor surname: Grantcharov fullname: Grantcharov, Teodor – sequence: 3 givenname: Krishna surname: Moorthy fullname: Moorthy, Krishna – sequence: 4 givenname: Thor surname: Milland fullname: Milland, Thor – sequence: 5 givenname: Pavlos surname: Papasavas fullname: Papasavas, Pavlos – sequence: 6 givenname: Aristotelis surname: Dosis fullname: Dosis, Aristotelis – sequence: 7 givenname: Fernando surname: Bello fullname: Bello, Fernando – sequence: 8 givenname: Ara surname: Darzi fullname: Darzi, Ara |
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Snippet | To assess the use of a synchronized video-based motion tracking device for objective, instant, and automated assessment of laparoscopic skill in the operating... The assessment of technical skills in the operating room is fundamental to the credentialing of surgeons for independent practice. This paper investigates the... |
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SubjectTerms | Biological and medical sciences Cholecystectomy, Laparoscopic - standards Clinical Competence Digestive system. Abdomen Endoscopy Feasibility Studies General aspects Humans Investigative techniques, diagnostic techniques (general aspects) Medical sciences Operating Rooms Original Reproducibility of Results Statistics, Nonparametric Time and Motion Studies |
Title | An Evaluation of the Feasibility, Validity, and Reliability of Laparoscopic Skills Assessment in the Operating Room |
URI | https://www.ncbi.nlm.nih.gov/pubmed/17522527 https://www.proquest.com/docview/70525556 https://pubmed.ncbi.nlm.nih.gov/PMC1876956 http://doi.org/10.1097/01.sla.0000262780.17950.e5 |
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