D'Angelo Anne-Lise D, Rutherford Drew N, Ray Rebecca D, Laufer Shlomi, Mason Andrea, Pugh Carla M
Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave, K6/135 CSC, Madison, WI, 53792, USA. Electronic address: ad'
Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave, K6/135 CSC, Madison, WI, 53792, USA; Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, WI, USA.
Am J Surg. 2016 Feb;211(2):445-50. doi: 10.1016/j.amjsurg.2015.10.005. Epub 2015 Nov 11.
The aim of this study was to evaluate working volume as a potential assessment metric for open surgical tasks.
Surgical attendings (n = 6), residents (n = 4), and medical students (n = 5) performed a suturing task on simulated connective tissue (foam), artery (rubber balloon), and friable tissue (tissue paper). Using a motion tracking system, effective working volume was calculated for each hand. Repeated measures analysis of variance assessed differences in working volume by experience level, dominant and/or nondominant hand, and tissue type.
Analysis revealed a linear relationship between experience and working volume. Attendings had the smallest working volume, and students had the largest (P = .01). The 3-way interaction of experience level, hand, and material type showed attendings and residents maintained a similar working volume for dominant and nondominant hands for all tasks. In contrast, medical students' nondominant hand covered larger working volumes for the balloon and tissue paper materials (P < .05).
This study provides validity evidence for the use of working volume as a metric for open surgical skills. Working volume may provide a means for assessing surgical efficiency and the operative learning curve.
本研究旨在评估工作体积作为开放手术任务潜在评估指标的可行性。
外科主治医师（n = 6）、住院医师（n = 4）和医学生（n = 5）在模拟结缔组织（泡沫）、动脉（橡胶气球）和易碎组织（薄纸）上进行缝合任务。使用运动跟踪系统，计算每只手的有效工作体积。重复测量方差分析评估工作体积在经验水平、优势手和/或非优势手以及组织类型方面的差异。
分析显示经验与工作体积之间存在线性关系。主治医师的工作体积最小，医学生的最大（P = .01）。经验水平、手和材料类型的三因素交互作用表明，主治医师和住院医师在所有任务中优势手和非优势手的工作体积相似。相比之下，医学生的非优势手在处理气球和薄纸材料时覆盖的工作体积更大（P < .05）。
本研究为将工作体积用作开放手术技能评估指标提供了有效性证据。工作体积可能为评估手术效率和手术学习曲线提供一种方法。
