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Review
. 2017 Jun 21:19:301-325.
doi: 10.1146/annurev-bioeng-071516-044435. Epub 2017 Mar 27.

Objective Assessment of Surgical Technical Skill and Competency in the Operating Room

S Swaroop Vedula  1 , Masaru Ishii  2 , Gregory D Hager  1
Affiliations
Review

Objective Assessment of Surgical Technical Skill and Competency in the Operating Room

S Swaroop Vedula et al. Annu Rev Biomed Eng. .

Abstract

Training skillful and competent surgeons is critical to ensure high quality of care and to minimize disparities in access to effective care. Traditional models to train surgeons are being challenged by rapid advances in technology, an intensified patient-safety culture, and a need for value-driven health systems. Simultaneously, technological developments are enabling capture and analysis of large amounts of complex surgical data. These developments are motivating a "surgical data science" approach to objective computer-aided technical skill evaluation (OCASE-T) for scalable, accurate assessment; individualized feedback; and automated coaching. We define the problem space for OCASE-T and summarize 45 publications representing recent research in this domain. We find that most studies on OCASE-T are simulation based; very few are in the operating room. The algorithms and validation methodologies used for OCASE-T are highly varied; there is no uniform consensus. Future research should emphasize competency assessment in the operating room, validation against patient outcomes, and effectiveness for surgical training.

Keywords: OCASE; objective computer-aided surgical skill evaluation; objective skill assessment; surgical data science; surgical technical competence; surgical technical skill.

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Figures

Figure 1
Figure 1
Timelines showing major advances in surgical technique, education, and technical skill assessment. Major innovations in surgical technique are illustrated on the inside of the arc on the left. Landmarks in graduate surgical education in the United States are shown on the outside of the arc. Abbreviations: ACGME, Accreditation Council for Graduate Medical Education; NOTES, natural orifice transluminal endoscopic surgery; OSATS, objective structured assessment of technical skills.
Figure 2
Figure 2
Research questions for objective computer-aided skill evaluation (OCASE-T).
Figure 3
Figure 3
Data for objective computer-aided skill evaluation (OCASE-T) to support continuous improvement in surgical skill and patient care.
See this image and copyright information in PMC

References

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