Department of Computer Science, The Johns Hopkins University, Baltimore, MD 21287, USA.
Int Forum Allergy Rhinol. 2012 Nov;2(6):507-15. doi: 10.1002/alr.21053. Epub 2012 Jun 13.
Assessment of surgical skill plays a crucial role in determining competency, monitoring educational programs, and providing trainee feedback. With the changing health care environment, it will likely play an important role in credentialing and maintenance of certification. The ideal skill assessment tool should be unbiased, objective, and accurate. We hypothesize that tool-motion data-how a surgeon moves his/her instruments-and eye-gaze data-what a surgeon looks at when he/she operates-contain sufficient information to quantitatively and objectively evaluate surgical skill. We investigate this hypothesis by developing a statistical model of surgery and testing the model experimentally in the context of endoscopic sinus surgery (ESS).
A total of 378 trials were recorded from 7 expert and 13 novice surgeons while they were performing a series of 9 different ESS tasks. Data was collected using an electromagnetic tracker to record the surgeon's tool and endoscope motions. In addition, the location of surgeon's eye gaze was recorded using an infrared eye tracker camera. This data was fit to the statistical model and used to test the accuracy of skill assessment.
The skill of expert surgeons was identified correctly for 94.6% of tasks. For surgeries performed by novice surgeons the proposed model properly recognizes the skill level with 88.6% accuracy.
We present an objective and unbiased method for assessing the skill of endoscopic sinus surgeons. Experimental results show that the proposed method successfully identifies the skill levels of both expert and novice surgeons.
手术技能评估在确定能力、监测教育项目和为学员提供反馈方面起着至关重要的作用。随着医疗保健环境的变化，它可能在认证和维持认证方面发挥重要作用。理想的技能评估工具应该是公正、客观和准确的。我们假设工具运动数据（外科医生如何移动他/她的器械）和眼动数据（外科医生在操作时看什么）包含足够的信息，可以对手术技能进行定量和客观的评估。我们通过开发一种手术的统计模型并在鼻窦内窥镜手术（ESS）的背景下进行实验来验证这一假设。
总共从 7 名专家和 13 名新手外科医生中记录了 378 次试验，他们在进行一系列 9 个不同的 ESS 任务时进行了手术。数据是使用电磁跟踪器收集的，以记录外科医生的工具和内窥镜的运动。此外，还使用红外眼跟踪器相机记录了外科医生的眼睛注视位置。将这些数据拟合到统计模型中，并用于测试技能评估的准确性。
对于 94.6%的任务，专家外科医生的技能得到了正确识别。对于新手外科医生进行的手术，所提出的模型以 88.6%的准确率正确识别了技能水平。
我们提出了一种客观、公正的评估鼻窦内窥镜外科医生技能的方法。实验结果表明，所提出的方法成功地识别了专家和新手外科医生的技能水平。
