Assessment of competence in simulated flexible bronchoscopy using motion analysis

Area of Science:

• Medical simulation
• Respiratory medicine
• Surgical training technology

Background:

• Optimal flexible bronchoscopy requires correct posture and a straight scope to enhance performance and prevent injuries.
• Minimizing endoscope damage and operator strain is crucial during flexible bronchoscopy procedures.

Purpose of the Study:

• To evaluate an automatic motion analysis system for correlating scope movements with operator experience levels.
• To test the hypothesis that experienced bronchoscopists exhibit less scope movement and maintain a straighter flexible scope compared to novices.

Main Methods:

• Utilized a Microsoft Kinect system for automatic motion analysis during simulated bronchoscopy procedures.
• Measured total deviation of the flexible scope from a perfectly straight, vertical line.
• Assessed 11 novices, 9 intermediates, and 9 experienced operators performing three procedures each on a simulator.

Main Results:

• The motion analysis system precisely measured accumulated scope deviation.
• Novice operators showed the greatest scope deviations, while experienced operators exhibited the smallest (p = 0.01, p = 0.01, p = 0.04).
• Greater scope deviation negatively correlated with simulator performance scores (p < 0.001).

Conclusions:

• The motion analysis system effectively differentiated between varying levels of bronchoscopy operator experience.
• Automated feedback on scope handling during simulator training can aid novice bronchoscopists in achieving expert-level proficiency.