Idle time: an underdeveloped performance metric for assessing surgical skill

Abstract

Background The study aim was to evaluate validity evidence using idle time as a performance measure in open surgical skills assessment. Methods This pilot study tested psychomotor planning skills of surgical attendings (N=6), residents (N=4) and medical students (N=5) during suturing tasks of varying difficulty. Performance data were collected with a motion tracking system. Participants’ hand movements were analyzed for idle time, total operative time and path length. We hypothesized that there will be shorter idle times for more experienced individuals and on the easier tasks. Results A total of 365 idle periods were identified across all participants. Attendings had fewer idle periods during three specific procedure steps (p < .001). All participants had longer idle time on friable tissue (p < .005). Conclusion Using an experimental model, idle time was found to correlate with experience and motor planning when operating on increasingly difficult tissue types. Further work exploring idle time as a valid psychomotor measure is warranted.

Gaze entropy reflects surgical task load

“…The main limitations for subjectivebased methods rise in their off-line nature or the response biases related to personal and motivational factors [15]. Computer-based methods have very limited applicability outside expensive simulation laboratories [16,17]. Thus, the development of objective and feasible systems to assess surgical task load remains a major challenge in the healthcare field [18,19].…”

A marker-less technique for measuring kinematics in the operating room

“…In review of the literature, we identified recent work that similarly demonstrated varying kinematics when participants performed interrupted suture tasks on a variable tissue simulator. Specifically, on a model simulating friable tissue, participants had significantly increased idle time, 22 suture time, and path length 23 compared to arterial or fascial tissue models.…”

Advanced Engineering Technology for Measuring Performance

“…This technology can be highly useful in differentiating individual fingers in the recording of suturing skills where markers operate in close proximity to each other. 18 In addition, the IREDs are much brighter than a reflective marker and can be operated at much higher sampling frequencies and with greater accuracy than a passive system.…”

“…Performance in each of these measures is highly procedure specific, but the data provide useful predictors of skill, as they are shown to differ between novices and experts 12,17 as well as with task difficulty. 18 Motion capture technology spans a variety of methodologies and types of electronic sensors. Those most commonly used in the study of human performance of complex manual skills include (1) optical tracking, (2) accelerometry-based tracking, and (3) magnetic tracking.…”