An Objective Methodology to Quantify Motor Skills in Basic Orthopaedic and Gynecologic Surgical Tasks

Abstract

This study is the initial step in the development of a basic skills simulator for surgical residents, intended to serve as a cross-platform objective motor skills training system. A robust system was developed to measure motor skills of orthopaedic surgeons and gynecologic surgeons. The orthopaedic study focused on three basic skills: drill, tap, and screw insertion. Each of the participants repeated the sequential task of drill, tap, screw insertion ten times in cadaveric femoral diaphyseal bone. The gynecologic study focused on placement of sutures across ten incisions in synthetic skin. Real time wrist, hand, and finger position was recorded bilaterally using Immersion CyberGloves® and the Ascension Liberty Tracker®. Four metrics were evaluated: task duration, gesture proficiency, hand movement smoothness (replaced by subjective rating in Gyn study), and number of errors, in order to differentiate between groups with different skill levels: No Skills, Limited Skills, Advanced Skills, and Expert Skills. The results demonstrated a significant difference between the Expert Skills group and the less skilled groups. In both studies the Expert Skills group completed the tasks the fastest, with the greatest proficiency, smoothness and accuracy. These results establish the 5 capability of our present skill quantification system and will assist in future improvement of the analysis algorithm.