Surgical ergonomics. Analysis of technical skills, simulation models and assessment methods

Papaspyros, Sotiris; Kar, Ashok; O’Regan, David

doi:10.1016/j.ijsu.2015.04.047

Cited by 22 publications

(16 citation statements)

References 17 publications

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“…Similar surgical models have been shown to aid in teaching surgical skills and enhance surgical competency in a controlled, low-risk environment. 8 One limitation of this study is that data were collected for just a single session. In the future, data collected over multiple simulation sessions would be valuable.…”

Section: Discussionmentioning

confidence: 99%

Obliterated Posterior Cul-de-sac Laparoscopic Surgical Simulation

Senapati

Alsaden

Schroer

et al. 2021

Obstetrics &Amp; Gynecology

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BACKGROUND: Obliteration of the posterior cul-de-sac is a challenging, often unexpected surgical finding. Developing the dissection skills required to manage this finding during laparoscopy is essential for optimizing treatment of many pain disorders during hysterectomy or ovarian surgery; however, exposure of trainees to cul-de-sac dissection is variable. Currently, there are no widely available simulation models for teaching and practicing this technique. METHOD: Our aim is to design a low-cost and high-fidelity laparoscopic simulation model that represents key anatomical structures and emphasizes skills for laparoscopic dissection of an obliterated posterior cul-de-sac. EXPERIENCE: A three-dimensional model was created and is described. Nine experts (gynecologic surgery fellows and attendings) and 17 residents completed a single 30-minute simulation session and completed several assessments to begin establishing the face validity of this model. CONCLUSION: Experts and residents rated the obliterated cul-de-sac simulation as highly realistic and useful. Residents showed a statistically significant increase in comfort with the dissection, from a median Likert score of 1 out of 5 (interquartile range 1–1) to 3 out of 5 (interquartile range 2–3) (P<.001). Experts scored better than residents on blinded video grading of model performance (P<.001). This low-cost and easily reproducible model fills a critical gap in gynecologic surgery education.

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Section: Discussionmentioning

confidence: 99%

Obliterated Posterior Cul-de-sac Laparoscopic Surgical Simulation

Senapati

Alsaden

Schroer

et al. 2021

Obstetrics &Amp; Gynecology

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“…20 Despite this, many experienced surgeons believe gaining skill with the nondominant hand is critical for competency during surgery. [21][22][23] In this study, we define experts as those who have performed greater than 15 similar procedures, and we assume that experts will carry out an ''expert performance'' each time. Similarly, a ''novice performance'' is defined as one performed by an individual with limited experience performing similar tasks.…”

Section: Discussionmentioning

confidence: 99%

“…20 Despite this, many experienced surgeons believe gaining skill with the nondominant hand is critical for competency during surgery. 21-23…”

Section: Discussionmentioning

confidence: 99%

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Wrist Motion Variation between Novices and Experienced Surgeons Performing Simulated Airway Surgery

et al. 2017

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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.

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“…repetition. This can be done at home on low fidelity models that offer visible and tactile feedback [3].…”

Section: Introductionmentioning

confidence: 99%

Diastolic Learning: Making the Tacit, Explicit

Papaspyros¹

2018

EOIJ

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Introduction: Surgery is a motor skill that has to be learnt through practice. The acquisition of motor skills and the principles are well documented especially in sport. Deliberate practice is the engagement in structured activities created specifically to improve performance in a domain and requires feedback. The experience needed to become an expert can be helped in the early stages of training with deliberate practice and observation by a skilled trainer. The aim of this project is to establish whether a combination of low fidelity simulation models and deliberate practice can reliably predict achievement of basic surgical skills competency. Video based scoring was used to quantify progress. Methods: We recruited thirty junior doctors and medical students with minimal exposure to surgery. They were provided with appropriate instruments and materials. They were given a demonstration of low fidelity simulation models, principles of needle handling and feedback on their first attempts. An initial video was taken. Subsequently they were given specific exercises to practice at home. They were reassessed after a period of one week and a second video was taken. Results: The participants were scored on four parameters: Time/pace, flow/rhythm, precision, rotation. There was significant improvement on all four parameters in twenty-eight out of thirty participants. This ranged from 18.9% (time) to 40% (flow). Conclusion: This project has enhanced our knowledge and practice in surgical education and training. Our work provides evidence on how low-fidelity simulation models can reliably be used to achieve significant progress through early stages of the learning curve. Furthermore it demonstrates the principles that need to be observed in order for deliberate practice to be effective and efficient in acquisition of surgical skills.

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Surgical ergonomics. Analysis of technical skills, simulation models and assessment methods

Cited by 22 publications

References 17 publications

Obliterated Posterior Cul-de-sac Laparoscopic Surgical Simulation

Obliterated Posterior Cul-de-sac Laparoscopic Surgical Simulation

Wrist Motion Variation between Novices and Experienced Surgeons Performing Simulated Airway Surgery

Diastolic Learning: Making the Tacit, Explicit

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