Motion Metrics Reliably Differentiate Competency: Fundamentals of Endovascular and Vascular Surgery

Abstract

Objective: Vascular surgery is unique in that it combines intricate skill sets, involves almost every anatomic territory, and crosses over with other subspecialties. Recent editorial publications have insinuated that the interest in our specialty is declining. We sought to examine the relative interest in vascular surgery compared with interventional cardiology (IC), cardiothoracic surgery (CT), and interventional radiology (IR).Methods: Reviews of the National Residency Match Program and the American Board of Internal Medicine were performed for both fellowship and residency match data. Search terms were compared using Google trends. Job outlook was examined on the

Velocity-Domain Motion Quality Measures for Surgical Performance Evaluation and Feedback

“…Online performance assessment and feedback based on tool movement smoothness have the potential to positively impact endovascular surgical navigation training. In our previous findings, described in detail by Murali et al [23] and Belvroy et al [30], we determined that average velocity and idle time (the proportion of the motion profile consisting of idle tool movements [31]) of guidewire motion showed significant differences between experience level. These time-domain metrics also exhibited high linear correlations with SPARC and serve as indirect measures of frequency-domain movement smoothness [23].…”

“…4.2 Comparison of Online and Offline Calculation. Objective and quantitative performance metrics such as movement smoothness, average velocity, and idle time have significant potential for offline evaluation of endovascular surgical performance [23,30]. To investigate the utility of these metrics for online performance evaluation, the average value of each metric calculated during a navigation task using discrete and sliding windows of different duration and overlap was compared to SPARC calculated offline across the entire motion trial.…”

“…The number of endovascular procedures performed with and without supervision determined the experience level of each participant, as we have done in our prior work [16,23,30]. Novices were defined as individuals who had performed less than 50 cases; intermediates were defined as individuals who had performed between 50 and 500 cases; and experts were defined as individuals who had performed over 500 cases.…”

“…This comparison was performed using robust linear regression to minimize the effect of potential outlier data. These regression tests provided Pearson correlation coefficients that relate the average online values of each performance metric to the offline measure of SPARC shown to correlate with experience level from prior studies [23,30,34]. The evaluation of the online performance of each metric was carried out using motion trials corresponding to a single task, given the task dependence of movement smoothness metrics [29].…”

Pride and prejudice

“…The tool has been used to assess the differences between the novice and experienced operators using endovascular tools. Only this morning, we awarded the Peter B. Samuels award to Belvroy et al 3 from Houston Methodist for the report titled "Motion Metrics Reliably Differentiate Competency: Fundamentals of Endovascular and Vascular Surgery." We are able to see a real difference in experience and also use a scientific tool to assess technical skillsdone important component to becoming a competent surgeon.…”