Fundamental aspects of learning minimally invasive surgical skills

Dankelman, Jenny; Chmarra, Magdalena K.; Verdaasdonk, E. G. G.; Stassen, Laurents P. S.; Grimbergen, C.A.

doi:10.1080/13645700500272413

Cited by 62 publications

(54 citation statements)

References 26 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been demonstrated that neither one performance measure ñor efficiency metrics alone adequately measure competence, since competence is multi-factorial in nature, with knowledge, judgment, behavior, and technical abilities each playing a major role [60,61]. Therefore, various performance measures that are essential for surgical competence need to be taken into account.…”

Section: Clinical Definition Of Metricsmentioning

confidence: 99%

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

131

View full text Add to dashboard Cite

Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentortrainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons' psychomotor skills. Ongoing development of tracking systems and software Solutions has allowed for the expansión of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentáis of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as 1 To whom correspondence and reprint requests should be addressed at Bioengineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Universidad Politécnica de Madrid (UPM). Avda Complutense, 30, 28040, Madrid, Spain. E-mail: ioropesa@gbt.tfo. upm.es. well as optimize their already overloaded training schedules.

show abstract

Section: Clinical Definition Of Metricsmentioning

confidence: 99%

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

131

View full text Add to dashboard Cite

show abstract

“…Training results and expert feedback should be available, especially in the beginning, in order to avoid misapprehension (47). The exercises should include partial tasks, supportive feedback and several goals to strive for (46). Expertise in complex visuo-motor skills can not be reached without repetition and deliberate practice (48,49).…”

Section: Discussionmentioning

confidence: 99%

“…Learners should be enabled to follow their own progress and receive adequate feedback and evaluation (46). A simulator can be connected to an interactive social context in which facilitation and peer support promotes learning.…”

Section: Discussionmentioning

confidence: 99%

Virtual Reality Simulator Training of Laparoscopic Cholecystectomies — A Systematic Review

et al. 2012

View full text Add to dashboard Cite

Background and Aims: simulators are widely used in occupations where practice in authentic environments would involve high human or economic risks. surgical procedures can be simulated by increasingly complex and expensive techniques. this review gives an update on computer-based virtual reality (vr) simulators in training for laparoscopic cholecystectomies.Materials and Methods: from leading databases (medline, cochrane, embase), randomised or controlled trials and the latest systematic reviews were systematically searched and reviewed. twelve randomised trials involving simulators were identified and analysed, as well as four controlled studies. furthermore, seven studies comparing black boxes and simulators were included.Results: the results indicated any kind of simulator training (black box, vr) to be beneficial at novice level. after vr training, novice surgeons seemed to be able to perform their first live cholecystectomies with fewer errors, and in one trial the positive effect remained during the first ten cholecystectomies. no clinical follow-up data were found. optimal learning requires skills training to be conducted as part of a systematic training program. no data on the cost-benefit of simulators were found, the price of a vr simulator begins at eur 60 000.Conclusions: theoretical background to learning and limited research data support the use of simulators in the early phases of surgical training. the cost of buying and using simulators is justified if the risk of injuries and complications to patients can be reduced. Developing surgical skills requires repeated training. in order to achieve optimal learning a validated training program is needed.

show abstract

“…In order to develop an advanced and comprehensive objective assessment, a three-dimensional evaluation of trainees is necessary to obtain the right balance of attributes: A good knowledge base, surgical judgement and technical skills (59). Traditional evaluation methods for minimally invasive surgery based on subjective criteria suggest that an objective and automatic assessment method of surgical skills should be standardized to cope with mentors' and trainees' tight schedules, saving when possible the extra cost of having an experienced surgeon during the entire evaluation process, and as a means towards proficiencybased curricula for training in laparoscopic surgery and its certification.…”

Section: Discussionmentioning

confidence: 99%

Systems and technologies for objective evaluation of technical skills in laparoscopic surgery

Sánchez‐Margallo

García

et al. 2013

Minimally Invasive Therapy & Allied Technologies

View full text Add to dashboard Cite

Minimally invasive surgery is a highly demanding surgical approach regarding technical requirements for the surgeon, who must be trained in order to perform a safe surgical intervention. Traditional surgical education in minimally invasive surgery is commonly based on subjective criteria to quantify and evaluate surgical abilities, which could be potentially unsafe for the patient. Authors, surgeons and associations are increasingly demanding the development of more objective assessment tools that can accredit surgeons as technically competent. This paper describes the state of the art in objective assessment methods of surgical skills. It gives an overview on assessment systems based on structured checklists and rating scales, surgical simulators, and instrument motion analysis. As a future work, an objective and automatic assessment method of surgical skills should be standardized as a means towards proficiency-based curricula for training in laparoscopic surgery and its certification.

show abstract

Fundamental aspects of learning minimally invasive surgical skills

Cited by 62 publications

References 26 publications

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Virtual Reality Simulator Training of Laparoscopic Cholecystectomies — A Systematic Review

Systems and technologies for objective evaluation of technical skills in laparoscopic surgery

Contact Info

Product

Resources

About