Differences Between Attending and Trainee Surgeon Performance Using Objective Performance Indicators During...

Area of Science:

• Robotic Surgery
• Surgical Education
• Surgical Skill Assessment

Background:

• Current surgical performance assessments are subjective and biased.
• Objective performance indicators (OPIs) derived from robotic surgical systems can objectively differentiate technical skill.
• Robotic lobectomy (RL) offers a platform for evaluating these OPIs.

Purpose of the Study:

• To compare OPIs between surgical trainees and attending surgeons during robotic lobectomy.
• To assess the ability of OPIs to differentiate technical skill levels in robotic surgery.
• To evaluate the utility of a novel data recorder for capturing surgical performance metrics.

Main Methods:

• Fifty cardiothoracic surgery residents and 7 attending surgeons performed RL on a perfused ex vivo model.
• A novel recorder captured simultaneous video and system/instrument data.
• OPIs were analyzed for both hands across 6 discrete tasks, including exposure and stapling.

Main Results:

• Significant differences in OPIs were observed between attendings and trainees across all tasks.
• Trainees showed significant differences in 52% of left-hand and 70% of right-hand OPIs during exposure tasks.
• Trainees demonstrated significant differences in 47% of stapling-hand and 25% of non-stapling hand OPIs during stapling tasks.

Conclusions:

• A novel data and video recorder effectively generated OPIs, revealing significant differences in operative gestures between trainees and attendings during RL.
• This objective assessment method shows potential for establishing competency benchmarks in robotic surgery.
• OPIs can be utilized for tracking surgical skill progression in trainees.