Brandon Wickens1, Arefin Shamsil2, Murad Husein1, Lily H P Nguyen3,4,5, Philip C Doyle6, Lorne S Parnes1, Sumit K Agrawal1,2,7, Hanif M Ladak8,9,10. 1. Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada. 2. Department of Electrical & Computer Engineering, Western University, London, ON, Canada. 3. Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, QC, Canada. 4. Department of Pediatric Surgery, McGill University, Montreal, QC, Canada. 5. Institute of Health Sciences Education, McGill University, Montreal, QC, Canada. 6. Department of Otolaryngology-Head and Neck Surgery, Division of Laryngology, Stanford University School of Medicine, Stanford, CA, USA. 7. Department of Medical Biophysics, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada. 8. Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada. hladak@uwo.ca. 9. Department of Electrical & Computer Engineering, Western University, London, ON, Canada. hladak@uwo.ca. 10. Department of Medical Biophysics, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada. hladak@uwo.ca.
Abstract
PURPOSE: Learning to use a surgical microscope is a fundamental step in otolaryngology training; however, there is currently no objective method to teach or assess this skill. Tympanostomy tube placement is a common otologic procedure that requires skilled use of a surgical microscope. This study was designed to (1) implement metrics capable of evaluating microscope use and (2) establish construct validity. STUDY DESIGN: This was a prospective cohort study. METHODS: Eight otolaryngology trainees and three otolaryngology experts were asked to use a microscope to insert a tympanostomy tube into a cadaveric myringotomy in a standardized setting. Microscope movements were tracked in a three-dimensional space, and tracking metrics were applied to the data. The procedure was video-recorded and then analyzed by blinded experts using operational metrics. Results from both groups were compared, and discriminatory metrics were determined. RESULTS: The following tracking metrics were identified as discriminatory between the trainee and expert groups: total completion time, operation time, still time, and jitter (movement perturbation). Many operational metrics were found to be discriminatory between the two groups, including several positioning metrics, optical metrics, and procedural metrics. CONCLUSIONS: Performance metrics were implemented, and construct validity was established for a subset of the proposed metrics by discriminating between expert and novice participants. These discriminatory metrics could form the basis of an automated system for providing feedback to residents during training while using a myringotomy surgical simulator. Additionally, these metrics may be useful in guiding a standardized teaching and evaluation methodology for training in the use of surgical microscopes.
PURPOSE: Learning to use a surgical microscope is a fundamental step in otolaryngology training; however, there is currently no objective method to teach or assess this skill. Tympanostomy tube placement is a common otologic procedure that requires skilled use of a surgical microscope. This study was designed to (1) implement metrics capable of evaluating microscope use and (2) establish construct validity. STUDY DESIGN: This was a prospective cohort study. METHODS: Eight otolaryngology trainees and three otolaryngology experts were asked to use a microscope to insert a tympanostomy tube into a cadaveric myringotomy in a standardized setting. Microscope movements were tracked in a three-dimensional space, and tracking metrics were applied to the data. The procedure was video-recorded and then analyzed by blinded experts using operational metrics. Results from both groups were compared, and discriminatory metrics were determined. RESULTS: The following tracking metrics were identified as discriminatory between the trainee and expert groups: total completion time, operation time, still time, and jitter (movement perturbation). Many operational metrics were found to be discriminatory between the two groups, including several positioning metrics, optical metrics, and procedural metrics. CONCLUSIONS: Performance metrics were implemented, and construct validity was established for a subset of the proposed metrics by discriminating between expert and novice participants. These discriminatory metrics could form the basis of an automated system for providing feedback to residents during training while using a myringotomy surgical simulator. Additionally, these metrics may be useful in guiding a standardized teaching and evaluation methodology for training in the use of surgical microscopes.
Authors: Marco Agus; Andrea Giachetti; Enrico Gobbetti; Gianluigi Zanetti; Antonio Zorcolo; Nigel W John; Robert J Stone Journal: Stud Health Technol Inform Date: 2002
Authors: Madeleine de Lotbiniere-Bassett; Arthur Volpato Batista; Carolyn Lai; Trishia El Chemaly; Joseph Dort; Nikolas Blevins; Justin Lui Journal: Int J Comput Assist Radiol Surg Date: 2022-08-07 Impact factor: 3.421