Surgical skill–it’s not just in the hands
Last week, we hosted Mark Smith, MD and Kanav Kahol, PhD for an in-house seminar. Mark is the System Director of Simulation and Innovation at Banner Good Samaritan Hospital, and Kanav is an Assistant Professor in the Department of Biomedical Informatics at Arizona State University. We first met them at the Medicine Meets Virtual Reality Conference earlier this year, where they were demonstrating an innovative approach to preparing surgical residents to do procedures by practicing with the Nintendo Wii. They modified a Wiimote controller by connecting a laparoscopic probe and had surgical residents warm up with Marble Mania, a simple maze game, prior to doing a procedure on a surgical simulator. Their study showed that residents who practiced with the Wii and Marble Mania did significantly better than those who did not. But that was only the hook to get our attention. Mark and Kanav's presentation whetted our appetites with the range and direction of their research activities around skills and performance training and assessment.
For example
- Cognitive surgical simulators -- adding a layer of cognitive exercises (neuropsychological tasks) to basic simulators to provide more challenging exercises over and above psychomotor skills training
- Dynamic simulations -- an intelligent tutoring system that uses EEG to gage a surgeon's current proficiency and provides tasks and scenarios relevant to their skill level, enabling them to hone skills and focus on areas of weakness
- Visualizing surgical skill -- using real-time analysis to capture hand movement patterns of surgeons while completing a standardized task; comparing with database of novice to expert hand movements; and providing real-time feedback using a graphical hand display driven by a real-time data stream.
- Measuring movement expertise -- a promising approach to objectively evaluating surgical skills based on hand movement analysis instead of tool movement
- Fatigue effects -- focuses on effect of fatigue on surgical residents' cognitive skills during simulated surgical exercises
Some found discussion around cognitive capacity and introducing noise into the simulated environment to be particularly interesting as it related to some of our own BS topics around professional burnout and novice/expert performance. Others were interested in social networking experiments using smart cards. All were interested in further discussions around potential collaborations.
