Cullen Jackson, PhD1, Sudeep Hegde, PhD1, Jonah Cohen1, Mandeep Sawhney1, Daniel Jones1, Berk Cetinsaya2, Mark A Gromsky3, Sangrock Lee4, Zhaihui Xia4, Doga Demirel3, Tansel Halic5, Coskun Bayrak2, Suvranu De4. 1Beth Israel Deaconess Medical Center, 2University of Arkansas at Little Rock, 3Indiana University School of Medicine, 4Rensselaer Polytechnic Institute, 5University of Central Arkansas
INTRODUCTION: One of the key challenges to the proliferation of endoscopic submucosal dissection (ESD) in the West has been a lack of training platforms. Therefore, the Virtual Endoluminal Surgery Simulator (VESS) is being developed as a training tool for ESD. The aim of our study is to inform the design of VESS using Cognitive Task Analysis (CTA), which is a human factors engineering framework to describe practitioners’ mental models and cognitive processes and incorporate insights into the simulator’s design.
METHODS AND PROCEDURES: CTA-based interview questions were developed to probe the cognitive challenges and strategies employed at each stage of the ESD procedure. Six ESD practitioners were interviewed for varying lengths of time. Two of these interviews were conducted simultaneously during an observation of a training workshop where the CTA participants were instructors (total observation time was five hours, and interview time was ~60 minutes). Another interview was conducted during observation of ESD procedures (total observation time was 22 hours, and interview time was ~110 minutes). Participants had varying levels of experience in ESD, with 4 of them being ‘super-experts’ (exclusively ESD exponents), 1 an ‘expert’ and 1 a fellow. A CTA of the data is currently being conducted to systematically inform design of functionalities in the simulator.
RESULTS: Analysis of our data highlights a few prominent themes at each stage of ESD: goals, challenges (e.g., avoiding perforation of muscularis); points of decision-making (e.g.,partial or full incision for boundary demarcation); skills involved (e.g., dissection); and ambiguity (e.g., unclear lesion boundaries). Participants also described risks associated with each stage of ESD and strategies to prevent or overcome the same.
CONCLUSIONS: Qualitative data for a CTA were collected through observations and interviews of ESD practitioners. Preliminary analysis has indicated prominent themes to consider in the design of the training simulator. The next step in the study is to conduct a full-scale CTA of ESD based on the current data. The ultimate benefit of the CTA would be to incorporate the results into informing the design of VESS in a way that is compatible with the mental models of ESD trainees, thus enhancing the fidelity and effectiveness of the simulator.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88034
Program Number: P306
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster