Bin Zheng1, Bo Fu2, Thamer A Al-Tayeb3, Yi Fan Hao3, A Karim Qayumi3. 1. University of Alberta, Edmonton, Alberta, Canada bin.zheng@ualberta.ca. 2. University of Alberta, Edmonton, Alberta, Canada. 3. University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND: We examined the impact of tool complexity on surgeons' performance and evaluated the value of using a simulation-based program for reducing training cost. METHODS: Three pairs of surgical graspers with increasing mechanical complexity, which were designed for open, laparoscopic, and endoscopic procedures, were used in performing a simple object transportation task. Task times and mental workload of 17 surgeons were compared using all 3 variations of the graspers to test the impact of tool complexity on surgical performance. Subsequently, 4 of these surgeons decided to enter a 3-week training phase and practiced with these 3 surgical instruments on a daily basis. Learning curves were plotted to examine the value of using simulation for proficiency training with these tools. RESULTS: Task time was significantly prolonged as tool complexity increased. Practice in a simulated environment shortened the task time significantly and moderately reduced mental workloads. However, the difference in task time varied among the 3 types of tools. Between days 1 and 9, task times for each types of grasper were reduced by 55% (endoscopic), 42% (open), and 22% (laparoscopic). CONCLUSIONS: Tool complexity may degrade a surgeon's performance. Extensive simulation training programs are important for surgeons to gain proficiency in handling a tool before they practice on patients.
BACKGROUND: We examined the impact of tool complexity on surgeons' performance and evaluated the value of using a simulation-based program for reducing training cost. METHODS: Three pairs of surgical graspers with increasing mechanical complexity, which were designed for open, laparoscopic, and endoscopic procedures, were used in performing a simple object transportation task. Task times and mental workload of 17 surgeons were compared using all 3 variations of the graspers to test the impact of tool complexity on surgical performance. Subsequently, 4 of these surgeons decided to enter a 3-week training phase and practiced with these 3 surgical instruments on a daily basis. Learning curves were plotted to examine the value of using simulation for proficiency training with these tools. RESULTS: Task time was significantly prolonged as tool complexity increased. Practice in a simulated environment shortened the task time significantly and moderately reduced mental workloads. However, the difference in task time varied among the 3 types of tools. Between days 1 and 9, task times for each types of grasper were reduced by 55% (endoscopic), 42% (open), and 22% (laparoscopic). CONCLUSIONS: Tool complexity may degrade a surgeon's performance. Extensive simulation training programs are important for surgeons to gain proficiency in handling a tool before they practice on patients.