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Novel Use of Objective Sensor Technology: Creation of Individualized Education Plans to Develop Operative Mastery
James R Korndorffer1, Cameron Schultz, Calvin Perumalla
1From the Department of Surgery, Stanford University, Stanford, CA (Korndorffer, Schultz, Perumalla, Perrone, Pugh).
Background:
Motion tracking has been shown to correlate with expert and novice performance but has not been used for skill development. For skill development, performance goals must be defined. We hypothesize that by using wearable sensor technology, motion-tracking outcomes can be identified in those deemed practice ready (PR) and used as benchmarks for precision learning.
Study Design:
At the American College of Surgeons Clinical Congress, surgeons and surgeons in training volunteered to wear motion-tracking sensors while performing intracorporeal suturing and knot tying, laparoscopic pattern cutting, and simulated laparoscopic cholecystectomy. Coach raters evaluated the participants using a modified SIMPL scale. Participants were divided into 2 groups based on coach ratings: PR and not PR. Motion results were compared. Benchmark performance for each motion-tracking outcome of the simulated laparoscopic cholecystectomy was set at the median (±median absolute deviation) of the PR cohort. For all participants, each motion-tracking outcome was compared with the benchmark.
Results:
A total of 94 participants were recruited. Fifty-three were rated PR. Differences between groups were identified in 2 of 10 metrics for intracorporeal suturing and knot tying, 4 of 10 metrics for pattern cutting, and 5 of 10 metrics for laparoscopic cholecystectomy. Set benchmarks for the metrics were compared with each participant's score for all individual metrics. A not PR individual was less likely to achieve the benchmarks (chi-square = 55.48, p < 0.00001).
Conclusions:
Wearable sensor technology can identify differences between surgeons rated PR and not PR. More importantly, motion metric results can be used to develop benchmarks for training endpoints. This will allow for the development of an individualized report card and training protocol focused on areas in need of improvement instead of the current model of generalized training. Implementing such focused training may expedite competency and mastery of surgical skills.
