Development of a Web Application That Evaluates Suture Performance in Off-the-Job Training

Abstract

Objective: To create a web application that can evaluate suture performance and assess its quality. Material and Methods: We developed the web application using a few cloud computing systems, servers, database, and computing languages. We used 20 anastomosed graft samples for optimizing the application. The images of the anastomosed grafts were captured two-dimensionally. Five vascular surgeons utilized the application to compute the objective score and rank the score of the anastomoses subjectively. Results: Steps for using the application include uploading a two-dimensional image of sutures, tracing the stitch line manually, and pushing the button to have the score displayed. After using this system for more than 1,000 times without server issues or failures, we confirmed its stability and easy accessibility. The system calculated the score within several seconds. The score of the three factors (bite, pitch, and skewness of angle) ranged from 0.25 to 0.76. The error range of the application was acceptable. The interclass correlation coefficient (ICC (2,1)) of the three factors was 0.92. Conclusion: The quality of the application was acceptable considering the low range of interoperator variations in the scores.

Ten-Hour Simulation Training Improved the Suturing Performance of Medical Students

“…The anastomosed grafts were cut open (after undoing the last knot) to expose the entire circumference and placed between transparent acrylic plates. Two-dimensional images of the front and back were captured and uploaded to our web application for manual stitch-line tracing and anastomosis evaluation, as previously described (Figure 1A) [9].…”

“…Performance scores included the coefficient of variation (CV) of bite (length of a stitch across the graft), CV of pitch (interval between stitches), and skewness (symmetry of the angle among stitches). The total score was defined as the norm of the vectors of the CV of bite, CV of pitch, and skewness: ({(bite) 2 + (pitch) 2 + (skewness) 2 } 1/2 ) (Figure 1B) [8][9][10]. The score for time (minutes/stitch) was determined as the total procedural time divided by the number of stitches.…”

“…The optimized training methodology included instruction by vascular surgeons and use of established equipment, including prosthetic vascular grafts, sutures, and surgical instruments. In addition, an open access web application (https://ojt-suture-eval-240602.firebaseapp.com) was developed that calculated the performance scores for anastomosis within several seconds, allowing easy evaluation of training outcomes [9].…”

Social networking service messages improve novice trainees' motivation and performance of skills

“…Recently, the importance of off-the-job training (Off-JT) and On-JT for surgical skills training has been reported. 1 There are many reports that Off-JT using a dry box and virtual reality simulation improves skill performance. [1][2][3][4][5] Simulationbased training and virtual reality platforms have demonstrated success in augmenting surgical skills among trainees.…”

“…1 There are many reports that Off-JT using a dry box and virtual reality simulation improves skill performance. [1][2][3][4][5] Simulationbased training and virtual reality platforms have demonstrated success in augmenting surgical skills among trainees. 6 Additionally, the role of motivation in shaping surgical expertise has garnered attention, with studies highlighting its influence on trainees' performance, engagement, and career choices.…”