Abstract
Background. Recent attention has been directed at developing quantitative assessments of surgical
skill. This study aims to demonstrate whether objectively measuring differences in
manual dexterity has an impact on a simulated surgical procedure. Methods. Six general surgical trainees performed 5 polytetrafluoroethylene graft to artery
anastomoses on a vascular model by using a standardized technique. Manual dexterity
was objectively measured with (1) electromagnetic motion analysis: trackers applied
to the backs of hands recorded and analyzed both hand movements and procedural time
and (2) 4-parameter evaluation of the final product. Outcome parameters were assessed
by (1) rate of anastomotic leakage and (2) smallest cross-sectional area of the anastomosis.
Results. The 2 objective measures of manual dexterity correlated closely (Pearson coefficient,
0.423; P <.02). Trainees with better manual dexterity scores produced better outcome measures.
Those with better motion analysis scores produced anastomoses that leaked less (Pearson
coefficient, 0.514; P <.01) and those with higher global evaluation scores had a larger anastomotic cross-sectional
area (Pearson coefficient, 0.495; P <.01). Time taken for the procedure did not appear to influence either outcome measure.
Conclusions. There is a significant correlation between objective measures of manual dexterity
and the outcome measures in this model. This suggests that the outcome of a procedure
can be predicted by measuring surgical skill. (Surgery 2002;131:318-23.)
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Article info
Publication history
Accepted:
September 15,
2001
Footnotes
*Reprint requests: Vivek Datta, BSc, MBBS, Department of Surgical Oncology and Technology, l0th Floor, Queen Elizabeth the Queen Mother Building, St Mary's Hospital, London W2 1NY, UK.
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
