Surgical ergonomics - Analysis of technical skills, simulation models and assessment methods

ObjectiveTo determine whether wrist motion measured by a smartphone application can be used as a performance metric for a simulated airway procedure requiring both wrist and finger dexterity. We hypothesized that this accelerometer application could detect differences between novices and experienced surgeons performing simulated cricothyrotomy.SettingAcademic medical center.Study DesignProspective pilot cohort study.MethodsVoluntary surgeons and nonsurgeons were recruited. After viewing a training video, smartphones with accelerometer applications were attached to both wrists while subjects performed a cricothyrotomy on a validated task trainer. Procedure time and motion parameters, including average resultant acceleration (ARA), total resultant acceleration (TRA), and suprathreshold acceleration events (STAEs), were collected for dominant and nondominant hands. Subjects were stratified by prior experience. Blinded experts scored each performance using Objective Structured Assessment of Technical Skills (OSATS), and t tests were used to compare performance.ResultsThirty subjects were enrolled. Median age was 26 years, and 20 subjects were male. In the dominant hand, significant differences were seen between novice and experienced surgeons in TRA (P = .005) and procedure time (P = .006), while no significant differences were seen in STAEs (P = .42) and ARA (P = .33). In the nondominant hand, all variables were significantly different between the 2 groups: STAEs (P = .012), ARA (P = .007), TRA (P = .004), and procedure time (P = .006).ConclusionsWrist motion measured by a low-cost smartphone application can distinguish between novice and experienced surgeons performing simulated airway surgery. This tool provides cost-effective and objective performance feedback.

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“…20 Despite this, many experienced surgeons believe gaining skill with the nondominant hand is critical for competency during surgery. 21-23…”

Section: Discussionmentioning

confidence: 99%

Wrist Motion Variation between Novices and Experienced Surgeons Performing Simulated Airway Surgery

et al. 2017

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“…WMSD is the number one cause of absenteeism amongst healthcare workers, thus indirectly decreasing the healthcare workforce and consequently increasing the patient waiting time [ 42 ]. More importantly, WMSDs have been shown to reduce dexterity, range of motion, grip strength, and proprioception, with a direct impact on optimal patient’s care [ 30 , 37 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

Postural ergonomics and work-related musculoskeletal disorders in neurosurgery: lessons from an international survey

et al. 2021

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Background Work-related musculoskeletal disorders (WMSDs) affect a significant percentage of the neurosurgical workforce. The aim of the current questionnaire-based study was to examine the prevalence of WMSDs amongst neurosurgeons, identify risk factors, and study the views of neurosurgeons regarding ergonomics. Methods From June to August 2020, members of the “European Association of Neurosurgical Societies,” the “Neurosurgery Research Listserv,” and the “Latin American Federation of Neurosurgical Societies” were asked to complete an electronic questionnaire on the topics of WMSDs and ergonomics. Results A total of 409 neurosurgeons responded to the survey, with a 4.7 male to female ratio. Most of the surgeons worked in Europe (76.9%) in academic public hospitals. The vast majority of the participants (87.9%) had experienced WMSDs, mainly affecting the shoulder, neck, and back muscles. The most common operations performed by the participants were “Craniotomy for convexity/intrinsic tumors” (24.1%) and “Open lumbar basic spine” (24.1%). Neurosurgeons agreed that ergonomics is an underexposed area in the neurosurgical field (84.8%) and that more resources should be spend (87.3%) and training curricula changes should be made (78.3%) in order to alleviate the burden of WMSDs on neurosurgeons. Univariate analysis did not reveal any associations between the development of WMSDs and age, gender, tenure, average duration of operation, operating time per week, type of operation, and surgical approach. Conclusions The problem of WMSDs ought to be more closely addressed and managed by the neurosurgical community. More studies ought to be designed to investigate specific ergonomic parameters in order to formulate practice recommendations.

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Surgical ergonomics - Analysis of technical skills, simulation models and assessment methods

Cited by 2 publications

References 15 publications

Wrist Motion Variation between Novices and Experienced Surgeons Performing Simulated Airway Surgery

Wrist Motion Variation between Novices and Experienced Surgeons Performing Simulated Airway Surgery

Postural ergonomics and work-related musculoskeletal disorders in neurosurgery: lessons from an international survey

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