Related Experiment Video
Updated: Feb 17, 2026
Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
The hands and head of a surgeon: Modeling operative competency with multimodal epistemic network analysis
A R Ruis1, Alexandra A Rosser1, Cheyenne Quandt-Walle2
1University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Madison, WI 53792, USA; University of Wisconsin-Madison, Wisconsin Center for Education Research, 1025 West Johnson Street, Madison, WI 53706, USA.
Background:
This paper explores a method for assessing intraoperative performance by modeling how surgeons integrate psychomotor, procedural, and cognitive skills to manage errors.
Methods:
Audio-video data were collected from general surgery residents (N = 45) performing a simulated laparoscopic ventral hernia repair. Errors were identified using a standard checklist, and speech was coded for elements related to error recognition and management. Epistemic network analysis (ENA) was used to model the integration of error management skills.
Results:
There was no correlation between number or type of errors committed and operative outcome. However, ENA models showed significant differences in the integration of error management skills between high-performing and low-performing residents.
Conclusion:
These results suggest that error checklists and surgeons' speech can be used to model the integration of psychomotor, procedural, and cognitive aspects of intraoperative performance. Moreover, ENA can identify and quantify this integration, providing insight on performance gaps in both individuals and populations.
