Korndorffer James R, Schultz Cameron, Perumalla Calvin, Perrone Kenneth, Pugh Carla M
From the Department of Surgery, Stanford University, Stanford, CA (Korndorffer, Schultz, Perumalla, Perrone, Pugh).
J Am Coll Surg. 2025 Apr 1;240(4):638-645. doi: 10.1097/XCS.0000000000001286. Epub 2025 Mar 17.
Motion tracking has been shown to correlate with expert and novice performance but has not been used for skill development. For skill development, performance goals must be defined. We hypothesize that by using wearable sensor technology, motion-tracking outcomes can be identified in those deemed practice ready (PR) and used as benchmarks for precision learning.
At the American College of Surgeons Clinical Congress, surgeons and surgeons in training volunteered to wear motion-tracking sensors while performing intracorporeal suturing and knot tying, laparoscopic pattern cutting, and simulated laparoscopic cholecystectomy. Coach raters evaluated the participants using a modified SIMPL scale. Participants were divided into 2 groups based on coach ratings: PR and not PR. Motion results were compared. Benchmark performance for each motion-tracking outcome of the simulated laparoscopic cholecystectomy was set at the median (±median absolute deviation) of the PR cohort. For all participants, each motion-tracking outcome was compared with the benchmark.
A total of 94 participants were recruited. Fifty-three were rated PR. Differences between groups were identified in 2 of 10 metrics for intracorporeal suturing and knot tying, 4 of 10 metrics for pattern cutting, and 5 of 10 metrics for laparoscopic cholecystectomy. Set benchmarks for the metrics were compared with each participant's score for all individual metrics. A not PR individual was less likely to achieve the benchmarks (chi-square = 55.48, p < 0.00001).
Wearable sensor technology can identify differences between surgeons rated PR and not PR. More importantly, motion metric results can be used to develop benchmarks for training endpoints. This will allow for the development of an individualized report card and training protocol focused on areas in need of improvement instead of the current model of generalized training. Implementing such focused training may expedite competency and mastery of surgical skills.
运动追踪已被证明与专家和新手的表现相关，但尚未用于技能发展。对于技能发展，必须定义表现目标。我们假设，通过使用可穿戴传感器技术，可以在那些被认为具备练习条件（PR）的人身上识别运动追踪结果，并将其用作精准学习的基准。
在美国外科医师学会临床大会上，外科医生和正在接受培训的外科医生在进行体内缝合和打结、腹腔镜图案切割以及模拟腹腔镜胆囊切除术时自愿佩戴运动追踪传感器。教练评分员使用改良的SIMPL量表对参与者进行评估。根据教练评分将参与者分为两组：PR组和非PR组。比较运动结果。模拟腹腔镜胆囊切除术的每个运动追踪结果的基准表现设定为PR队列的中位数（±中位数绝对偏差）。对于所有参与者，将每个运动追踪结果与基准进行比较。
共招募了94名参与者。53人被评为PR。在体内缝合和打结的10项指标中有2项、图案切割的10项指标中有4项以及腹腔镜胆囊切除术的10项指标中有5项发现了组间差异。将指标的设定基准与每个参与者所有个体指标的得分进行比较。非PR个体达到基准的可能性较小（卡方 = 55.48，p < 0.00001）。
可穿戴传感器技术可以识别被评为PR和非PR的外科医生之间的差异。更重要的是，运动指标结果可用于制定训练终点的基准。这将有助于制定个性化的成绩单和训练方案，重点关注需要改进的领域，而不是当前的通用训练模式。实施这种针对性训练可能会加快手术技能的能力培养和掌握。
