Impact of a Wireless System Upon Verbal Communication in a Simulated Robotic Operating Theater

Alexander, Thomas; Campwala, Zahabiya; Keheila, Mohamed; Ruckle, David; Pierce, Matthew; Mattison, Braden; West, Benjamin; Thomas, Jerry; Hogue, Patrick; Abourbih, Samuel; Baldwin, D. Duane

doi:10.1016/j.urology.2018.07.059

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Frequency of agreements ( n = 1) and response accuracy ( n = 2) were also included. Agreement in the study represented if participants were in agreement for a surgical decision (Bezemer et al, 2016), and response accuracy reflected the metric of the number of correct words or phrases that was recorded by listening subjects from a speaking participant (e.g., surgeon; Cheriyan et al, 2016; Thomas et al, 2019). Response accuracy was included in experimental studies and reflect surgeon NTS on an individual level and was not dependent on the communication within a team.…”

Section: Resultsmentioning

confidence: 99%

Objective Measures of Surgeon Non-Technical Skills in Surgery: A Scoping Review

Cha

2021

Hum Factors

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Objective The purpose of this study was to identify, synthesize, and discuss objective behavioral or physiological metrics of surgeons’ nontechnical skills (NTS) in the literature. Background NTS, or interpersonal or cognitive skills, have been identified to contribute to safe and efficient surgical performance; however, current assessments are subjective, checklist-based tools. Intraoperative skill evaluation, such as technical skills, has been previously utilized as an objective measure to address such limitations. Methods Five databases in engineering, behavioral science, and medicine were searched following PRISMA reporting guidelines. Eligibility criteria included studies with NTS objective measurements, surgeons, and took place within simulated or live operations. Results Twenty-three articles were included in this review. Objective metrics included communication metrics and measures from physiological responses such as changes in brain activation and motion of the eye. Frequencies of content-coded communication in surgery were utilized in 16 studies and were associated with not only the communication construct but also cognitive constructs of situation awareness and decision making. This indicates the underlying importance of communication in evaluating the NTS constructs. To synthesize the scoped literature, a framework based on the one-way communication model was used to map the objective measures to NTS constructs. Conclusion Objective NTS measurement of surgeons is still preliminary, and future work on leveraging objective metrics in parallel with current assessment tools is needed. Application Findings from this work identify objective NTS metrics for measurement applications in a surgical environment.

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Section: Resultsmentioning

confidence: 99%

Objective Measures of Surgeon Non-Technical Skills in Surgery: A Scoping Review

Cha

2021

Hum Factors

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“…During a robotic-assisted procedure, the surgeon sits on a console away from the patient bed and surgical team which may change NTS demands (Catchpole et al, 2019; Yu et al, 2017); specifically, there are increased communication, teamwork, and workflow challenges due to the spatial separation (Randell et al, 2016; Tiferes et al, 2019). Thomas et al (2019) reported communication impediment from robotic speaker systems, while Weigl et al (2018) found equipment- or communication-related disruptions that were associated with poor self-perceived teamwork. Objective NTS measurement during robotic-assisted procedures can help identify teamwork challenges to improve intraoperative performance and safety; therefore, they were selected as the study environment.…”

Section: Methodsmentioning

confidence: 99%

Objective Nontechnical Skills Measurement Using Sensor-based Behavior Metrics in Surgical Teams

et al. 2022

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Objective The purpose of this study was to identify objective measures that predict surgeon nontechnical skills (NTS) during surgery. Background NTS are cognitive and social skills that impact operative performance and patient outcomes. Current methods for NTS assessment in surgery rely on observation-based tools to rate intraoperative behavior. These tools are resource intensive (e.g., time for observation or manual labeling) to perform; therefore, more efficient approaches are needed. Method Thirty-four robotic-assisted surgeries were observed. Proximity sensors were placed on the surgical team and voice recorders were placed on the surgeon. Surgeon NTS was assessed by trained observers using the NonTechnical Skills for Surgeons (NOTSS) tool. NTS behavior metrics from the sensors included communication, speech, and proximity features. The metrics were used to develop mixed effect models to predict NOTSS score and in machine learning classifiers to distinguish between exemplar NTS scores (highest NOTSS score) and non-exemplar scores. Results NTS metrics were collected from 16 nurses, 12 assistants, 11 anesthesiologists, and four surgeons. Nineteen behavior features and overall NOTSS score were significantly correlated (12 communication features, two speech features, five proximity features). The random forest classifier achieved the highest accuracy of 70% (80% F1 score) to predict exemplar NTS score. Conclusion Sensor-based measures of communication, speech, and proximity can potentially predict NOTSS scores of surgeons during robotic-assisted surgery. These sensing-based approaches can be utilized for further reducing resource costs of NTS and team performance assessment in surgical environments. Application Sensor-based assessment of operative teams’ behaviors can lead to objective, real-time NTS measurement.

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