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. 2017 Nov 8;1(4):2473974X17738959.
doi: 10.1177/2473974X17738959. eCollection 2017 Oct-Dec.

Wrist Motion Variation between Novices and Experienced Surgeons Performing Simulated Airway Surgery

Edward Callahan  1 , Randall Bly  1 , Kaalan Johnson  1 , Nava Aghdasi  2 , Blake Hannaford  2 , Kris Moe  1 , Maya G Sardesai  1
Affiliations

Wrist Motion Variation between Novices and Experienced Surgeons Performing Simulated Airway Surgery

Edward Callahan et al. OTO Open. .

Abstract

Objective: To determine whether wrist motion measured by a smartphone application can be used as a performance metric for a simulated airway procedure requiring both wrist and finger dexterity. We hypothesized that this accelerometer application could detect differences between novices and experienced surgeons performing simulated cricothyrotomy.

Setting: Academic medical center.

Study design: Prospective pilot cohort study.

Methods: Voluntary surgeons and nonsurgeons were recruited. After viewing a training video, smartphones with accelerometer applications were attached to both wrists while subjects performed a cricothyrotomy on a validated task trainer. Procedure time and motion parameters, including average resultant acceleration (ARA), total resultant acceleration (TRA), and suprathreshold acceleration events (STAEs), were collected for dominant and nondominant hands. Subjects were stratified by prior experience. Blinded experts scored each performance using Objective Structured Assessment of Technical Skills (OSATS), and t tests were used to compare performance.

Results: Thirty subjects were enrolled. Median age was 26 years, and 20 subjects were male. In the dominant hand, significant differences were seen between novice and experienced surgeons in TRA (P = .005) and procedure time (P = .006), while no significant differences were seen in STAEs (P = .42) and ARA (P = .33). In the nondominant hand, all variables were significantly different between the 2 groups: STAEs (P = .012), ARA (P = .007), TRA (P = .004), and procedure time (P = .006).

Conclusions: Wrist motion measured by a low-cost smartphone application can distinguish between novice and experienced surgeons performing simulated airway surgery. This tool provides cost-effective and objective performance feedback.

Keywords: airway; cricothyroidotomy; simulation; smartphone; surgical training; wrist motion.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1.
Figure 1.
Photograph of assembly of wrist-mounted smartphones and cricothyrotomy simulator.
Figure 2.
Figure 2.
Average overall procedure time for each experience level.
Figure 3.
Figure 3.
Total resultant acceleration comparing novices and experts in both dominant and nondominant wrists.
Figure 4.
Figure 4.
Average resultant acceleration comparing novices and experts in both dominant and nondominant wrists.
Figure 5.
Figure 5.
Suprathreshold acceleration events comparing novices and experts in both dominant (P = .42) and nondominant wrists (P = .012).
See this image and copyright information in PMC

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