Simulator-Based Metrics for Quantifying Vascular Palpation Skill for Cannulation

Petersen, Lydia; Liu, Zhanhe; Bible, Joe; Shukla, Devansh; Singapogu, Ravikiran B.

doi:10.1109/access.2022.3184303

Cited by 2 publications

(2 citation statements)

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“…11 In line with this, our team has developed a "smart" cannulation simulator with the ability to comprehensively quantify cannulation skill. [12][13][14][15][16][17] In this work-and to the best of our knowledge, for the first time-we present a simulator-based, quantitative study examining the relationship between needle angles, cannulation outcomes, and cannulation skill from a cohort of nurses and PCTs. Toward this, we introduce three kinds of novel angle metrics on the basis of needle insertion angle profiles during cannulation to quantify cannulation performance.…”

Section: Introductionmentioning

confidence: 99%

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Needle Angle Matters: An Investigation of the Effect of Needle Angle on Hemodialysis Cannulation Skill

et al. 2023

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Background: Cannulation is critical for maintaining a functional vascular access for patients on hemodialysis. However, relatively little is known about the quantitative aspects of needle insertion dynamics required for skilled cannulation. In this paper, we introduce three kinds of metrics that quantify needle insertion angle — recognized as important for safe and effective cannulation — during cannulation on an instrumented simulator for skill assessment. Three questions were examined in this study: (1) Are simulator-based needle angle metrics related to cannulation success? (2) Are needle angle metrics related to simulated blood flashback quality? (3) Can needle angle metrics be used to distinguish between high and low skill levels? Methods: Fifty-one cannulators with varying degrees of clinical experience performed cannulation on the instrumented simulator. Each participant cannulated 16 times on different fistulas with varying geometries. During each trial, needle angle along with other sensor data was obtained via a motion sensor placed inside the needle. Data analysis was conducted by relating needle angle over time with our previously validated simulator-based cannulation outcome metrics. Results: Results revealed that all three types of needle angle metrics were useful in predicting the probability of cannulation success. In addition, they were also correlated to flashback quality metrics. Furthermore, these metrics successfully distinguished between high and low performers regardless of whether they were classified using subjective ratings or objective scores. These results indicate that needle insertion angle is an important component of cannulation skill. Conclusions: The simulator-based metrics for needle insertion angle presented in this work measure a key aspect of skilled cannulation. As such, if implemented in a structured way, these metrics could lead to competency-based skill assessment and training for cannulation in the future. Raising the bar of cannulation skill of our clinicians can have a tangible impact on patient outcomes.

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Section: Introductionmentioning

confidence: 99%

“… 11 In line with this, our team has developed a “smart” cannulation simulator with the ability to comprehensively quantify cannulation skill. 12 – 17 …”

Section: Introductionmentioning

confidence: 99%

Needle Angle Matters: An Investigation of the Effect of Needle Angle on Hemodialysis Cannulation Skill

et al. 2023

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An objective skill assessment framework for microsurgical anastomosis based on ALI scores

Gholami,

Manon,

Yao

et al. 2024

Acta Neurochir

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Introduction The current assessment and standardization of microsurgical skills are subjective, posing challenges in reliable skill evaluation. We aim to address these limitations by developing a quantitative and objective framework for accurately assessing and enhancing microsurgical anastomosis skills among surgical trainees. We hypothesize that this framework can differentiate the proficiency levels of microsurgeons, aligning with subjective assessments based on the ALI score. Methods We select relevant performance metrics from the literature on laparoscopic skill assessment and human motor control studies, focusing on time, instrument kinematics, and tactile information. This information is measured and estimated by a set of sensors, including cameras, a motion capture system, and tactile sensors. The recorded data is analyzed offline using our proposed evaluation framework. Our study involves 12 participants of different ages ($$35.42\pm 9.78$$ 35.42 ± 9.78 years) and genders (nine males and three females), including six novice and six intermediate subjects, who perform surgical anastomosis procedures on a chicken leg model. Results We show that the proposed set of objective and quantitative metrics to assess skill proficiency aligns with subjective evaluations, particularly the ALI score method, and can effectively differentiate novices from more proficient microsurgeons. Furthermore, we find statistically significant disparities, where microsurgeons with intermediate level of skill proficiency surpassed novices in both task speed, reduced idle time, and smoother, briefer hand displacements. Conclusion The framework enables accurate skill assessment and provides objective feedback for improving microsurgical anastomosis skills among surgical trainees. By overcoming the subjectivity and limitations of current assessment methods, our approach contributes to the advancement of surgical education and the development of aspiring microsurgeons. Furthermore, our framework emerges to precisely distinguish and classify proficiency levels (novice and intermediate) exhibited by microsurgeons.

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Simulator-Based Metrics for Quantifying Vascular Palpation Skill for Cannulation

Cited by 2 publications

References 43 publications

Needle Angle Matters: An Investigation of the Effect of Needle Angle on Hemodialysis Cannulation Skill

Needle Angle Matters: An Investigation of the Effect of Needle Angle on Hemodialysis Cannulation Skill

An objective skill assessment framework for microsurgical anastomosis based on ALI scores

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