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Surgical Endoscopy

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01-08-2019

Objective assessment of surgical skill transfer using non-invasive brain imaging

Authors: Arun Nemani, Uwe Kruger, Clairice A. Cooper, Steven D. Schwaitzberg, Xavier Intes, Suvranu De

Published in: Surgical Endoscopy | Issue 8/2019

Abstract

Background

Physical and virtual surgical simulators are increasingly being used in training technical surgical skills. However, metrics such as completion time or subjective performance checklists often show poor correlation to transfer of skills into clinical settings. We hypothesize that non-invasive brain imaging can objectively differentiate and classify surgical skill transfer, with higher accuracy than established metrics, for subjects based on motor skill levels.

Study design

18 medical students at University at Buffalo were randomly assigned into control, physical surgical trainer, or virtual trainer groups. Training groups practiced a surgical technical task on respective simulators for 12 consecutive days. To measure skill transfer post-training, all subjects performed the technical task in an ex-vivo environment. Cortical activation was measured using functional near-infrared spectroscopy (fNIRS) in the prefrontal cortex, primary motor cortex, and supplementary motor area, due to their direct impact on motor skill learning.

Results

Classification between simulator trained and untrained subjects based on traditional metrics is poor, where misclassification errors range from 20 to 41%. Conversely, fNIRS metrics can successfully classify physical or virtual trained subjects from untrained subjects with misclassification errors of 2.2% and 8.9%, respectively. More importantly, untrained subjects are successfully classified from physical or virtual simulator trained subjects with misclassification errors of 2.7% and 9.1%, respectively.

Conclusion

fNIRS metrics are significantly more accurate than current established metrics in classifying different levels of surgical motor skill transfer. Our approach brings robustness, objectivity, and accuracy in validating the effectiveness of future surgical trainers in translating surgical skills to clinically relevant environments.

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Title: Objective assessment of surgical skill transfer using non-invasive brain imaging
Authors: Arun Nemani
Uwe Kruger
Clairice A. Cooper
Steven D. Schwaitzberg
Xavier Intes
Suvranu De
Publication date: 01-08-2019
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 8/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6535-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Objective assessment of surgical skill transfer using non-invasive brain imaging

Abstract

Background

Study design

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Study design

Results

Conclusion

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