TY - JOUR
T1 - Utilization of Flexible-Wearable Sensors to Describe the Kinematics of Surgical Proficiency
AU - Zulbaran-Rojas, Alejandro
AU - Najafi, Bijan
AU - Arita, Nestor
AU - Rahemi, Hadi
AU - Razjouyan, Javad
AU - Gilani, Ramyar
N1 - Funding Information:
This work was supported in part by the National Institutes of Health/National Institute on Aging (award number 1R42AG060853-01). The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsor. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/6
Y1 - 2021/6
N2 - Background: Traditional assessment (e.g., checklists, videotaping) for surgical proficiency may lead to subjectivity and does not predict performance in the clinical setting. Hand motion analysis is evolving as an objective tool for grading technical dexterity; however, most devices accompany with technical limitations or discomfort. We purpose the use of flexible wearable sensors to evaluate the kinematics of surgical proficiency. Methods: Surgeons were recruited and performed a vascular anastomosis task in a single institution. A modified objective structured assessment of technical skills (mOSATS) was used for technical qualification. Flexible wearable sensors (BioStamp RCTM, mc10 Inc., Lexington, MA) were placed on the dorsum of the dominant hand (DH) and nondominant hand (nDH) to measure kinematic parameters: path length (Tpath), mean (Vmean) and peak (Vpeak) velocity, number of hand movements (Nmove), ratio of DH to nDH movements (rMov), and time of task (tTask) and further compared with the mOSATS score. Results: Participants were categorized as experts (n = 12) and novices (n = 8) based on a cutoff mean mOSATS score. Significant differences for tTask (P = 0.02), rMov (P = 0.07), DH Tpath (P = 0.04), Vmean (P = 0.07), Vpeak (P = 0.04), and nDH Nmove (P = 0.02) were in favor of the experts. Overall, mOSATS had significant correlation with tTask (r = −0.69, P = 0.001), Nmove of DH (r = −0.44, P = 0.047) and nDH (r = −0.66, P = 0.001), and rMov (r = 0.52, P = 0.017). Conclusions: Hand motion analysis evaluated by flexible wearable sensors is feasible and informative. Experts utilize coordinated two-handed motion, whereas novices perform one-handed tasks in a hastily jerky manner. These tendencies create opportunity for improvement in surgical proficiency among trainees.
AB - Background: Traditional assessment (e.g., checklists, videotaping) for surgical proficiency may lead to subjectivity and does not predict performance in the clinical setting. Hand motion analysis is evolving as an objective tool for grading technical dexterity; however, most devices accompany with technical limitations or discomfort. We purpose the use of flexible wearable sensors to evaluate the kinematics of surgical proficiency. Methods: Surgeons were recruited and performed a vascular anastomosis task in a single institution. A modified objective structured assessment of technical skills (mOSATS) was used for technical qualification. Flexible wearable sensors (BioStamp RCTM, mc10 Inc., Lexington, MA) were placed on the dorsum of the dominant hand (DH) and nondominant hand (nDH) to measure kinematic parameters: path length (Tpath), mean (Vmean) and peak (Vpeak) velocity, number of hand movements (Nmove), ratio of DH to nDH movements (rMov), and time of task (tTask) and further compared with the mOSATS score. Results: Participants were categorized as experts (n = 12) and novices (n = 8) based on a cutoff mean mOSATS score. Significant differences for tTask (P = 0.02), rMov (P = 0.07), DH Tpath (P = 0.04), Vmean (P = 0.07), Vpeak (P = 0.04), and nDH Nmove (P = 0.02) were in favor of the experts. Overall, mOSATS had significant correlation with tTask (r = −0.69, P = 0.001), Nmove of DH (r = −0.44, P = 0.047) and nDH (r = −0.66, P = 0.001), and rMov (r = 0.52, P = 0.017). Conclusions: Hand motion analysis evaluated by flexible wearable sensors is feasible and informative. Experts utilize coordinated two-handed motion, whereas novices perform one-handed tasks in a hastily jerky manner. These tendencies create opportunity for improvement in surgical proficiency among trainees.
KW - Hand motion analysis
KW - Objective assessment
KW - Surgical proficiency
KW - Wearable sensors
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U2 - 10.1016/j.jss.2021.01.006
DO - 10.1016/j.jss.2021.01.006
M3 - Article
C2 - 33581385
AN - SCOPUS:85100678391
SN - 0022-4804
VL - 262
SP - 149
EP - 158
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -