Research article summary:

Psychomotor skills assessment in practicing surgeons experienced in performing advanced laparoscopic procedures.

Abstract Extract:
BACKGROUND: Minimally invasive surgery (MIS) has introduced a new and unique set of psychomotor skills for a surgeon to acquire and master. Although assessment technologies have been proposed, precise and objective psychomotor skills assessment of ... (Full abstract text below)

Published 2003Sep in Journal: J Am Coll Surg (Language : eng)

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1. J Am Coll Surg. 2003 Sep;197(3):479-88

Psychomotor skills assessment in practicing surgeons experienced in performing advanced laparoscopic procedures.

Gallagher AG, Smith CD, Bowers SP, Seymour NE, Pearson A, McNatt S, Hananel D, Satava RM

Department of Surgery, University of Washington Medical Center, Seattle, WA, USA.

BACKGROUND: Minimally invasive surgery (MIS) has introduced a new and unique set of psychomotor skills for a surgeon to acquire and master. Although assessment technologies have been proposed, precise and objective psychomotor skills assessment of surgeons performing laparoscopic procedures has not been detailed. STUDY DESIGN: Two hundred ten surgeons attending the 2001 annual meeting of the American College of Surgeons in New Orleans who reported having completed more than 50 laparoscopic procedures participated. Subjects were required to complete one box-trainer laparoscopic cutting task and a similar virtual reality task. These tasks were specifically designed to test only psychomotor and not cognitive skills. Both tasks were completed twice. Performance of tasks was assessed and analyzed. Demographic and laparoscopic experience data were also collected. RESULTS: Complete data were available on 195 surgeons. In this group, surgeons performed the box-trainer task better with their dominant hand (p < 0.0001) and there was a strong and statistically significant correlation between trials (r = 0.47 - 0.64, p < 0.0001). After transforming raw data to z-scores (mean = 0 and SD = 1) it was shown that between 2% and 12% of surgeons performed more than two standard deviations from the mean. Some surgeons' performance was 20 standard deviations from the mean. Minimally Invasive Surgical Trainer Virtual Reality metrics demonstrated high measurement consistency as assessed by coefficient alpha (alpha = 0.849). CONCLUSIONS: Objective assessment of laparoscopic psychomotor skills is now possible. Surgeons who had performed more than 50 laparoscopic procedures showed considerable variability in their performance on a simple laparoscopic and virtual reality task. Approximately 10% of surgeons tested performed the task significantly worse than the group's average performance. Studies such as this may form the methodology for establishing criteria levels and performance objectives in objective assessment of the technical skills component of determining surgical competence.

PMID : 12946803 [PubMed - Indexed for MEDLINE]

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Full Author Information

First Name	LastName	Initials
Anthony G	Gallagher	AG
C Daniel	Smith	CD
Steven P	Bowers	SP
Neal E	Seymour	NE
Adam	Pearson	A
Steven	McNatt	S
David	Hananel	D
Richard M	Satava	RM

Affiliation: Department of Surgery, University of Washington Medical Center, Seattle, WA, USA.

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