Yuanyuan Feng1, Katie Li2, Ivan George3, Hamid Zahiri3, Helena Mentis1. 1University of Maryland, Baltimore County, 2Pomona College, 3Anna Arundel Mendical Center
INTRODUCTION: Effective learning to become competent in surgery depends on a trainee’s ability to accurately recognize their strengths and weaknesses. However, a surgical trainee’s self-assessment is poorly correlated with expert assessment. This study aimed to improve self-assessment by the visual gaze guidance provided through telestration in laparoscopic training. We hypothesized that visual conveyance of where to look or perform actions on the laparoscopic video enhances the trainees’ awareness of the gaps in their skills and knowledge.
METHODS AND PROCEDURES: A lab-developed telestration system that enables the trainer to point or draw a free hand sketch over a laparoscopic video was used in the study (Figure 1). Seven surgical trainees (1 surgical fellow, 1 research fellow, 2 PYG-2 and 3 PYG-1) participated in a counterbalanced, within subjects controlled experiment, comparing standard guidance with telestration-supplemented guidance. The trainees performed four laparoscopic cholecystectomy tasks – mobilizing cystic duct and artery, clipping the duct, clipping the artery, and cutting the duct and artery, on a laparoscopic simulation. Performance assessment, adapted from the global rating scale (GRS) instrument, was completed by the trainers and trainees at the end of each task. The mean self-assessment scores were compared with the trainers’ scores by the linear mixed model, where the trainees’ performance indicated by the trainers’ scores was control. The assessment alignment was evaluated by Spearman’s Rho.
Figure 1. User interface of the telestration system.
RESULTS: The trainers’ scores were significantly lower than the self-assessment scores in the standard guidance, while the scores of the trainers and trainees were much more similar (Figure 2).
Figure 2. Mean assessment scores.
The correlation between the trainers’ and trainees’ assessment in telestration guidance was high (r = 0.852, p < 0.001), compared to the standard guidance (r = 0.569, p = 0.03). The correlation comparison for each GRS criterion shows a significant increase (p = 0.005) in the assessment alignment for depth perception in telestration guidance (r = 0.90, p < 0.001), compared to the standard guidance (r = 0.30, p = 0.31) (Figure 3).
Figure 3. Scatter plots for the performance assessment between trainers and trainees.
CONCLUSIONS: The visual gaze guidance improved the alignment of assessment between the trainer and trainees, especially for the assessment alignment in depth perception. For visual gaze guidance to become an integrated part of the training, further work needs to be conducted to understand how gaze guidance change the nature of the training process.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88450
Program Number: P296
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster