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J Surg Educ. 2015 Sep-Oct;72(5):910-7. doi: 10.1016/j.jsurg.2015.04.023. Epub 2015 Jun 15.

Objective Surgical Skill Assessment: An Initial Experience by Means of a Sensory Glove Paving the Way to Open Surgery Simulation?

Author information

1
Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy. Electronic address: saggio@uniroma2.it.
2
Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
3
Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy.
4
Biostatistics office, L'altrastatistica srl-Consultancy & Training, Rome, Italy.

Abstract

INTRODUCTION:

Simulation and training in surgery are very promising tools for enhancing a surgeon's skill base. Accurate tracking of hand movements can be a strategy for objectively gauging a surgeon's dexterity, although "open" work is much more difficult to evaluate than are laparoscopic tasks. To the authors' knowledge, a system taking into account the movements of each finger joint has never been applied to open surgery simulation. This work intends to make up for this shortcoming and to perform a data analysis of the surgeon's entire gesture.

MATERIALS AND METHODS:

The authors developed a sensory glove to measure flexion/extension of each finger joint and wrist movement. Totally 9 experts and 9 novices performed a basic suturing task and their manual performances were recorded within 2 days of measurements. Intraclass correlation coefficients were calculated to assess the ability of the executors to repeat and reproduce the proposed exercise. Wilcoxon signed-rank tests and Mann-Whitney U-tests were used to determine whether the 2 groups differ significantly in terms of execution time, repeatability, and reproducibility. Finally, a questionnaire was used to gather operators' subjective opinions.

RESULTS:

The experts needed a similar reduced execution time comparing the 2 recording sessions (p = 0.09), whereas novices spent more time during the first day (p = 0.01). Repeatability did not differ between the 2 days, either for experts (p = 0.26) or for novices (p = 0.86). The 2 groups performed differently in terms of time (p < 0.001), repeatability (p = 0.01), and reproducibility (p < 0.001) of the same gesture. The system showed an overall moderate repeatability (intraclass correlation coefficient: experts = 0.64; novices = 0.53) and an overall high reproducibility. The questionnaire revealed performers' positive feedback with the glove.

CONCLUSIONS:

This initial experience confirmed the validity and reliability of the proposed system in objectively assessing surgeons' technical skill, thus paving the way to a more complex project involving open surgery simulation.

KEYWORDS:

Medical Knowledge; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; assessment; education; open surgery; sensory glove; skill

PMID:
26089159
DOI:
10.1016/j.jsurg.2015.04.023
[Indexed for MEDLINE]

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