From the Department of Surgery (W.H.), University of Manitoba, Winnipeg, Manitoba; Department of Computer Science (X.J.), Memorial University of Newfoundland, St. John's, Newfoundland and Labrador; and Department of Surgery (B.Z.), University of Alberta, Edmonton, Alberta, Canada.
Simul Healthc. 2021 Dec 1;16(6):e206-e213. doi: 10.1097/SIH.0000000000000548.
Modern surgery crucially relies on teamwork between surgeons and assistants. The science of teamwork has been and is being studied extensively although the use of specific objective methodologies such as shared pupil dilations has not been studied as sufficiently as subjective methods. In this study, we investigated team members' shared pupil dilations as a surrogate for surgeon's team performance during a simulated laparoscopic procedure.
Fourteen subjects formed dyad teams to perform a simulated laparoscopic object transportation task. Both team members' pupil dilation and eye gaze were tracked simultaneously during the procedure. Video analysis was used to identify key event movement landmarks for subtask segmentation to facilitate data analysis. Three levels of each teams' performance were determined according to task completion time and accuracy (object dropping times). The determined coefficient of determination (R2) was used to calculate the similarity in pupil dilations between 2 individual members' pupil diameters in each team. A mixed-design analysis of variance was conducted to explore how team performance level and task type were correlated to joint pupil dilation.
The results showed that pupil dilations of higher performance teams were more synchronized, with significantly higher similarities (R2) in pupil dilation patterns between team members than those of lower performance teams (0.36 ± 0.22 vs. 0.21 ± 0.14, P < 0.001).
Levels of pupil dilation synchronization presented among teams reflect differences in performance levels while executing simulated laparoscopic tasks; this demonstrated the potential of using joint pupil dilation as an objective indicator of surgical teamwork performance.
现代外科手术在很大程度上依赖于外科医生和助手之间的团队合作。尽管使用了共享瞳孔扩张等特定的客观方法，但团队科学一直在被广泛研究，而没有像主观方法那样被充分研究。在这项研究中，我们研究了团队成员的瞳孔扩张作为模拟腹腔镜手术中外科医生团队表现的替代指标。
14 名受试者组成二人小组，执行模拟腹腔镜物体运输任务。在手术过程中，同时跟踪两名团队成员的瞳孔扩张和眼球注视。视频分析用于识别关键事件运动地标，以便进行子任务分割，从而便于数据分析。根据任务完成时间和准确性（物体掉落次数）确定每个团队的三个表现水平。确定系数（R2）用于计算每个团队中两名成员的瞳孔直径之间瞳孔扩张的相似性。进行混合设计方差分析，以探讨团队绩效水平和任务类型与联合瞳孔扩张的相关性。
结果表明，表现更好的团队的瞳孔扩张更为同步，团队成员之间的瞳孔扩张模式具有更高的相似性（R2）（0.36 ± 0.22 与 0.21 ± 0.14，P < 0.001）。
团队之间呈现的瞳孔扩张同步水平反映了执行模拟腹腔镜任务时的绩效水平差异；这表明联合瞳孔扩张有潜力作为手术团队合作表现的客观指标。
