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A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills
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Clinical study of skill assessment based on time sequential measurement changes.

Tomoko Yamaguchi1,2, Ryoichi Nakamura3, Akihito Kuboki4

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This study introduces a surgical workflow analysis to automatically detect errors in endoscopic sinus surgery. The method compares expert and resident surgical techniques to identify areas for skill improvement and enhance patient safety.

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Area of Science:

  • Medical Engineering
  • Surgical Innovation
  • Data Science in Medicine

Background:

  • Chronic sinusitis is commonly treated with endoscopic sinus surgery.
  • Surgical complications can arise, highlighting the need for improved surgeon skills.
  • Objective assessment of surgical technique is crucial for training and patient safety.

Purpose of the Study:

  • To develop and validate an automated method for identifying surgical errors in endoscopic sinus surgery using workflow analysis.
  • To compare surgical procedures performed by experts and residents to pinpoint skill discrepancies.
  • To establish a system for efficient identification of areas for surgical technique improvement.

Main Methods:

  • Quantified surgical features from log data, including instrument tip position and timestamps.
  • Developed a surgical process model (SPM) to represent the temporal transitions of surgical features.
  • Created an expert standard SPM and compared it with novice SPMs to detect technical issues.

Main Results:

  • Successfully identified 303 error portions across six categories from 39 patient cases.
  • Detected three overlooked risky operations and 11 overdetected errors.
  • The majority of detected errors were associated with potential surgical risks.

Conclusions:

  • Automated detection of surgical errors using workflow analysis is feasible and effective.
  • This method can efficiently highlight areas for improvement in surgical technique.
  • Implementation may lead to reduced review time and enhanced surgical skill development, potentially improving patient outcomes.