ObjectiveTo determine whether wrist motion measured by a smartphone application can be
used as a performance metric for a simulated airway procedure requiring both
wrist and finger dexterity. We hypothesized that this accelerometer
application could detect differences between novices and experienced
surgeons performing simulated cricothyrotomy.SettingAcademic medical center.Study DesignProspective pilot cohort study.MethodsVoluntary surgeons and nonsurgeons were recruited. After viewing a training
video, smartphones with accelerometer applications were attached to both
wrists while subjects performed a cricothyrotomy on a validated task
trainer. Procedure time and motion parameters, including average resultant
acceleration (ARA), total resultant acceleration (TRA), and suprathreshold
acceleration events (STAEs), were collected for dominant and nondominant
hands. Subjects were stratified by prior experience. Blinded experts scored
each performance using Objective Structured Assessment of Technical Skills
(OSATS), and t tests were used to compare performance.ResultsThirty subjects were enrolled. Median age was 26 years, and 20 subjects were
male. In the dominant hand, significant differences were seen between novice
and experienced surgeons in TRA (P = .005) and procedure
time (P = .006), while no significant differences were seen
in STAEs (P = .42) and ARA (P = .33). In
the nondominant hand, all variables were significantly different between the
2 groups: STAEs (P = .012), ARA (P =
.007), TRA (P = .004), and procedure time
(P = .006).ConclusionsWrist motion measured by a low-cost smartphone application can distinguish
between novice and experienced surgeons performing simulated airway surgery.
This tool provides cost-effective and objective performance feedback.