Utilization of the ProAnalyst motion analysis software, in simulation-based performance assessment

John C Kubasiak, MD, Sam C Klonoski, MD, Samantha Millikan, Benjamin Veenstra, MD, Jose Velasco, MD, Minh B Luu, MD. Rush University Medical Center

Technology Objective: The tools for objective assessment of operative skills, both in training and practice, are lacking. Motion analysis is an emerging field using various metrics aimed to reliably differentiate levels of technical performance. We sought to utilize a commercially available motion tracking software, ProAnalyst, on previously recorded Fundamentals of Laparoscopic Surgery (FLS) tasks as a proof of concept to obtain similar objective task analysis.

Methods: Resident performance of FLS peg transfer was recorded and scored. Scoring was based on FLS recommendations. Motion tracking analysis was performed using commercially available software Xcitex – ProAnalyst (Boston, MA. 2016). Total time, path length, velocity and acceleration were recorded for each hand. SPSS software v 23.0 was used to analyze results.

Preliminary Results: Nineteen PGY 1-5 residents completed the peg transfer successfully per FLS requirements. No participant went over time, inappropriately transferred pegs or dropped peg off field. Average time, path length, velocity and acceleration data were evaluated with Analysis of variance (ANOVA) across PGY year. Significant differences between the average speed (p> 0.001) and the average acceleration (p=0.003) of the non-dominant hand were present across the PGY level. Similar differences were seen in the average speed (p=0.01) and the average acceleration (p=0.012) of the dominant hand across the PGY level. Trend to significance was seen in the distance traveled for each instrument and the total time taken for the task by PGY level. Figure 1 demonstrates a sample analysis.

Conclusion: The commercially available motion analysis software, ProAnalyst, can be used to provide objective measurements of laparoscopic task trainer skills. Metrics such as average speed and acceleration can be used to differentiate PGY levels. This suggests there are alternate metrics, which might be able to objectively evaluate surgical skill. This technology can be applied to intra-operative video post-hoc. Further investigations with this technology will include application to more advanced simulation tasks and intra-operative videos.