Using apprenticeship communication flow as an ergonomic design input for future OR systems

Removing the gallbladder is a relatively simple laparoscopic operation. Tissue trauma, caused by laparoscopic cholecystectomy, is usually minimal. Misidentifying the cystic duct and artery and the common hepatic duct represents the most severe complication. However, the Critical View of Safety (CVS) technique reduces the risk of trauma, by accomplishing a safe 360 degrees identification of the cystic duct origin at the gallbladder neck [5]. This technique is employed and trained at the Erasmus Medical Centre (EMC), Rotterdam, The Netherlands. This study presents the potential value of a training device which residents can use during practice. This training device must cover both user friendliness and information supply. The current information supply was studied subjectively; the CVS protocol and the users' experience were studied both objectively and subjectively. The results of these studies show that the present information supply is not satisfactory, that there is a CVS protocol which can be easily used in a training device, and that most actions defining the cystic duct during operation revert on users' experience. Therefore, it is desirable to design a new training device according to the experience of the target group and the protocols, and taking into account an optimal human-product interaction.