Wenjing He1, Bin Zheng2. 1. Surgical Simulation Research Lab, Department of Surgery, University of Alberta, Edmonton, AB, Canada. 2. Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 162 Heritage Medical Research Centre, 8440 112 St. NW., Edmonton, AB, T6G 2E1, Canada. bin.zheng@ualberta.ca.
Abstract
OBJECTIVES: To examine the frequency of movement de-synchronization between a surgeon and assistant in a laparoscopic simulation task, and test whether it can be a valid behavior marker for team performance. METHODS: Fourteen subjects formed a total of 22 dyad teams. Each team performed a laparoscopic task where the camera driver navigated a laparoscope for the operator to transport a plastic cylinder between targets. Key movement landmarks were annotated from recorded surgical videos and were used to identify team behaviors and performance. Task completion time, number of movement de-synchronization, and errors (cylinder drops) were compared over 3 performance groups (elite, intermediate, poor) and 2 types of movements (on-site manipulation vs. position-shifting. RESULTS: Task completion time of elite teams was shorter than intermediate and poor teams (33.3 vs. 66.8 vs. 141.2 s, P < 0.001). Elite teams made fewer errors (0.1 vs. 0.5 vs. 0.9, P = 0.063) and recorded fewer numbers of de-synchronization than poor teams (2.9 vs. 3.0 vs. 4.9, P = 0.009). We also found that the on-site manipulation took longer task time (113.5 vs. 51.2 s, P < 0.001) and recorded fewer de-synchronization (0.6 vs. 5.3, P < 0.001) than position-shifting tasks. However, there is no significance in the measure of errors (P = 0.029). Interaction effects were revealed between performance groups and two movement types in task time (P = 0.010) and movement de-synchronization (P = 0.003). CONCLUSIONS: Video analysis is a useful tool for identifying team behaviors during surgery. Movement de-synchronization between surgeons and assistant reveals team cooperation in laparoscopic procedure. The evidence where de-synchronization occurred frequently during the position-shifting tasks rather than during the on-site manipulation suggests team collaborative behaviors can be affected by different task requirements.
OBJECTIVES: To examine the frequency of movement de-synchronization between a surgeon and assistant in a laparoscopic simulation task, and test whether it can be a valid behavior marker for team performance. METHODS: Fourteen subjects formed a total of 22 dyad teams. Each team performed a laparoscopic task where the camera driver navigated a laparoscope for the operator to transport a plastic cylinder between targets. Key movement landmarks were annotated from recorded surgical videos and were used to identify team behaviors and performance. Task completion time, number of movement de-synchronization, and errors (cylinder drops) were compared over 3 performance groups (elite, intermediate, poor) and 2 types of movements (on-site manipulation vs. position-shifting. RESULTS: Task completion time of elite teams was shorter than intermediate and poor teams (33.3 vs. 66.8 vs. 141.2 s, P < 0.001). Elite teams made fewer errors (0.1 vs. 0.5 vs. 0.9, P = 0.063) and recorded fewer numbers of de-synchronization than poor teams (2.9 vs. 3.0 vs. 4.9, P = 0.009). We also found that the on-site manipulation took longer task time (113.5 vs. 51.2 s, P < 0.001) and recorded fewer de-synchronization (0.6 vs. 5.3, P < 0.001) than position-shifting tasks. However, there is no significance in the measure of errors (P = 0.029). Interaction effects were revealed between performance groups and two movement types in task time (P = 0.010) and movement de-synchronization (P = 0.003). CONCLUSIONS: Video analysis is a useful tool for identifying team behaviors during surgery. Movement de-synchronization between surgeons and assistant reveals team cooperation in laparoscopic procedure. The evidence where de-synchronization occurred frequently during the position-shifting tasks rather than during the on-site manipulation suggests team collaborative behaviors can be affected by different task requirements.
Keywords:
Collaborative behaviors; Laparoscopic surgery; Surgical simulation; Team collaboration; Video analysis