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PLoS One. 2016 Mar 7;11(3):e0149174. doi: 10.1371/journal.pone.0149174. eCollection 2016.

Analysis of the Structure of Surgical Activity for a Suturing and Knot-Tying Task.

Author information

1
Department of Computer Science, The Johns Hopkins University, Baltimore, Maryland, United States of America.
2
Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, Maryland, United States of America.
3
Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland, United States of America.
4
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

Abstract

BACKGROUND:

Surgical tasks are performed in a sequence of steps, and technical skill evaluation includes assessing task flow efficiency. Our objective was to describe differences in task flow for expert and novice surgeons for a basic surgical task.

METHODS:

We used a hierarchical semantic vocabulary to decompose and annotate maneuvers and gestures for 135 instances of a surgeon's knot performed by 18 surgeons. We compared counts of maneuvers and gestures, and analyzed task flow by skill level.

RESULTS:

Experts used fewer gestures to perform the task (26.29; 95% CI = 25.21 to 27.38 for experts vs. 31.30; 95% CI = 29.05 to 33.55 for novices) and made fewer errors in gestures than novices (1.00; 95% CI = 0.61 to 1.39 vs. 2.84; 95% CI = 2.3 to 3.37). Transitions among maneuvers, and among gestures within each maneuver for expert trials were more predictable than novice trials.

CONCLUSIONS:

Activity segments and state flow transitions within a basic surgical task differ by surgical skill level, and can be used to provide targeted feedback to surgical trainees.

PMID:
26950551
PMCID:
PMC4780814
DOI:
10.1371/journal.pone.0149174
[Indexed for MEDLINE]
Free PMC Article

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