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Howie EE, Harari R, Dias RD, Wigmore SJ, Skipworth RJE, Yule S. Feasibility of Wearable Sensors to Assess Cognitive Load During Clinical Performance: Lessons Learned and Blueprint for Success. J Surg Res 2024; 302:222-231. [PMID: 39106733 DOI: 10.1016/j.jss.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/23/2024] [Accepted: 07/02/2024] [Indexed: 08/09/2024]
Abstract
INTRODUCTION Cognitive load (CogL) is increasingly recognized as an important resource underlying operative performance. Current innovations in surgery aim to develop objective performance metrics via physiological monitoring from wearable digital sensors. Surgeons have access to consumer technology that could measure CogL but need guidance regarding device selection and implementation. To realize the benefits of surgical performance improvement these methods must be feasible, incorporating human factors usability and design principles. This paper aims to evaluate the feasibility of using wearable sensors to assess CogL, identify the benefits and challenges of implementing devices, and develop guidance for surgeons planning to implement wearable devices in their research or practice. METHODS We examined the feasibility of wearable sensors from a series of empirical studies that measured aspects of clinical performance relating to CogL. Across four studies, 84 participants and five sensors were involved in the following clinical settings: (i) real intraoperative surgery; (ii) simulated laparoscopic surgery; and (iii) medical team performance outside the hospital. RESULTS Wearable devices worn on the wrist and chest were found to be comfortable. After a learning curve, electrodermal activity data were easily and reliably collected. Devices using photoplethysmography to determine heart rate variability were significantly limited by movement artifact. There was variable success with electroencephalography devices regarding connectivity, comfort, and usability. CONCLUSIONS It is feasible to use wearable sensors across various clinical settings, including surgery. There are some limitations, and their implementation is context and device dependent. To scale sensor use in clinical research, surgeons must embrace human factors principles to optimize wearability, usability, reliability, and data security.
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Affiliation(s)
- Emma E Howie
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland.
| | - Ryan Harari
- Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland; STRATUS Centre for Medical Simulation, Brigham & Women's Hospital, Boston, Massachusetts; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Roger D Dias
- Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland; STRATUS Centre for Medical Simulation, Brigham & Women's Hospital, Boston, Massachusetts; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Stephen J Wigmore
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland
| | - Richard J E Skipworth
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland
| | - Steven Yule
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland; Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, Scotland.
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Harari RE, Dias RD, Kennedy-Metz LR, Varni G, Gombolay M, Yule S, Salas E, Zenati MA. Deep Learning Analysis of Surgical Video Recordings to Assess Nontechnical Skills. JAMA Netw Open 2024; 7:e2422520. [PMID: 39083274 PMCID: PMC11292454 DOI: 10.1001/jamanetworkopen.2024.22520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/08/2024] [Indexed: 08/03/2024] Open
Abstract
Importance Assessing nontechnical skills in operating rooms (ORs) is crucial for enhancing surgical performance and patient safety. However, automated and real-time evaluation of these skills remains challenging. Objective To explore the feasibility of using motion features extracted from surgical video recordings to automatically assess nontechnical skills during cardiac surgical procedures. Design, Setting, and Participants This cross-sectional study used video recordings of cardiac surgical procedures at a tertiary academic US hospital collected from January 2021 through May 2022. The OpenPose library was used to analyze videos to extract body pose estimations of team members and compute various team motion features. The Non-Technical Skills for Surgeons (NOTSS) assessment tool was employed for rating the OR team's nontechnical skills by 3 expert raters. Main Outcomes and Measures NOTSS overall score, with motion features extracted from surgical videos as measures. Results A total of 30 complete cardiac surgery procedures were included: 26 (86.6%) were on-pump coronary artery bypass graft procedures and 4 (13.4%) were aortic valve replacement or repair procedures. All patients were male, and the mean (SD) age was 72 (6.3) years. All surgical teams were composed of 4 key roles (attending surgeon, attending anesthesiologist, primary perfusionist, and scrub nurse) with additional supporting roles. NOTSS scores correlated significantly with trajectory (r = 0.51, P = .005), acceleration (r = 0.48, P = .008), and entropy (r = -0.52, P = .004) of team displacement. Multiple linear regression, adjusted for patient factors, showed average team trajectory (adjusted R2 = 0.335; coefficient, 10.51 [95% CI, 8.81-12.21]; P = .004) and team displacement entropy (adjusted R2 = 0.304; coefficient, -12.64 [95% CI, -20.54 to -4.74]; P = .003) were associated with NOTSS scores. Conclusions and Relevance This study suggests a significant link between OR team movements and nontechnical skills ratings by NOTSS during cardiac surgical procedures, suggesting automated surgical video analysis could enhance nontechnical skills assessment. Further investigation across different hospitals and specialties is necessary to validate these findings.
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Affiliation(s)
| | - Roger D. Dias
- Mass General Brigham, Harvard Medical School, Boston, Massachusetts
| | | | - Giovanna Varni
- Department of Information Engineering and Computer Science, University of Trento, Trento, Italy
| | - Matthew Gombolay
- School of Interactive Computing, Georgia Institute of Technology, Atlanta
| | - Steven Yule
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom
| | - Eduardo Salas
- Department of Psychological Sciences, Rice University, Houston, Texas
| | - Marco A. Zenati
- Mass General Brigham, Harvard Medical School, Boston, Massachusetts
- VA Boston Healthcare System, West Roxbury, Massachusetts
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Norton J, Yule S, Darwood R. Human Factors in Vascular Surgery: A Glimpse into the Future. Eur J Vasc Endovasc Surg 2024:S1078-5884(24)00560-4. [PMID: 38936688 DOI: 10.1016/j.ejvs.2024.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/10/2024] [Accepted: 06/21/2024] [Indexed: 06/29/2024]
Affiliation(s)
- Joel Norton
- Edinburgh Surgical Sabermetrics Group, Usher Institute, University of Edinburgh, Edinburgh, UK; Department of Vascular Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK; Clinical Surgery, University of Edinburgh, Edinburgh, UK.
| | - Steven Yule
- Edinburgh Surgical Sabermetrics Group, Usher Institute, University of Edinburgh, Edinburgh, UK; Clinical Surgery, University of Edinburgh, Edinburgh, UK
| | - Rosie Darwood
- Leeds Vascular Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Howie EE, Ambler O, Gunn EG, Dias RD, Wigmore SJ, Skipworth RJ, Yule SJ. Surgical Sabermetrics: A Scoping Review of Technology-enhanced Assessment of Nontechnical Skills in the Operating Room. Ann Surg 2024; 279:973-984. [PMID: 38258573 PMCID: PMC11086675 DOI: 10.1097/sla.0000000000006211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
OBJECTIVE To evaluate the current evidence for surgical sabermetrics: digital methods of assessing surgical nontechnical skills and investigate the implications for enhancing surgical performance. BACKGROUND Surgeons need high-quality, objective, and timely feedback to optimize performance and patient safety. Digital tools to assess nontechnical skills have the potential to reduce human bias and aid scalability. However, we do not fully understand which of the myriad of digital metrics of performance assessment have efficacy for surgeons. METHODS A systematic review was conducted by searching PubMed, EMBASE, CINAHL, and PSYCINFO databases following PRISMA-ScR guidelines. MeSH terms and keywords included "Assessment," "Surgeons," and "Technology". Eligible studies included a digital assessment of nontechnical skills for surgeons, residents, and/or medical students within an operative context. RESULTS From 19,229 articles screened, 81 articles met the inclusion criteria. The studies varied in surgical specialties, settings, and outcome measurements. A total of 122 distinct objective, digital metrics were utilized. Studies digitally measured at least 1 category of surgical nontechnical skill using a single (n=54) or multiple objective measures (n=27). The majority of studies utilized simulation (n=48) over live operative settings (n=32). Surgical Sabermetrics has been demonstrated to be beneficial in measuring cognitive load (n=57), situation awareness (n=24), communication (n=3), teamwork (n=13), and leadership (n=2). No studies measured intraoperative decision-making. CONCLUSIONS The literature detailing the intersection between surgical data science and operative nontechnical skills is diverse and growing rapidly. Surgical Sabermetrics may provide a promising modifiable technique to achieve desirable outcomes for both the surgeon and the patient. This study identifies a diverse array of measurements possible with sensor devices and highlights research gaps, including the need for objective assessment of decision-making. Future studies may advance the integration of physiological sensors to provide a holistic assessment of surgical performance.
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Affiliation(s)
- Emma E. Howie
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland
- Edinburgh Surgical Sabermetrics Group, University of Edinburgh, Edinburgh, Scotland
| | - Olivia Ambler
- Edinburgh Surgical Sabermetrics Group, University of Edinburgh, Edinburgh, Scotland
| | - Eilidh G.M. Gunn
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland
- Edinburgh Surgical Sabermetrics Group, University of Edinburgh, Edinburgh, Scotland
| | - Roger D. Dias
- Edinburgh Surgical Sabermetrics Group, University of Edinburgh, Edinburgh, Scotland
- Human Factors and Cognitive Engineering Lab, STRATUS Centre for Medical Simulation, Brigham & Women’s Hospital, Boston, MA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA
| | - Stephen J. Wigmore
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland
- Edinburgh Surgical Sabermetrics Group, University of Edinburgh, Edinburgh, Scotland
| | - Richard J.E. Skipworth
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland
- Edinburgh Surgical Sabermetrics Group, University of Edinburgh, Edinburgh, Scotland
| | - Steven J. Yule
- Clinical Surgery, University of Edinburgh & Royal Infirmary of Edinburgh, Edinburgh, Scotland
- Edinburgh Surgical Sabermetrics Group, University of Edinburgh, Edinburgh, Scotland
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Constable MD, Shum HPH, Clark S. Enhancing surgical performance in cardiothoracic surgery with innovations from computer vision and artificial intelligence: a narrative review. J Cardiothorac Surg 2024; 19:94. [PMID: 38355499 PMCID: PMC10865515 DOI: 10.1186/s13019-024-02558-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
When technical requirements are high, and patient outcomes are critical, opportunities for monitoring and improving surgical skills via objective motion analysis feedback may be particularly beneficial. This narrative review synthesises work on technical and non-technical surgical skills, collaborative task performance, and pose estimation to illustrate new opportunities to advance cardiothoracic surgical performance with innovations from computer vision and artificial intelligence. These technological innovations are critically evaluated in terms of the benefits they could offer the cardiothoracic surgical community, and any barriers to the uptake of the technology are elaborated upon. Like some other specialities, cardiothoracic surgery has relatively few opportunities to benefit from tools with data capture technology embedded within them (as is possible with robotic-assisted laparoscopic surgery, for example). In such cases, pose estimation techniques that allow for movement tracking across a conventional operating field without using specialist equipment or markers offer considerable potential. With video data from either simulated or real surgical procedures, these tools can (1) provide insight into the development of expertise and surgical performance over a surgeon's career, (2) provide feedback to trainee surgeons regarding areas for improvement, (3) provide the opportunity to investigate what aspects of skill may be linked to patient outcomes which can (4) inform the aspects of surgical skill which should be focused on within training or mentoring programmes. Classifier or assessment algorithms that use artificial intelligence to 'learn' what expertise is from expert surgical evaluators could further assist educators in determining if trainees meet competency thresholds. With collaborative efforts between surgical teams, medical institutions, computer scientists and researchers to ensure this technology is developed with usability and ethics in mind, the developed feedback tools could improve cardiothoracic surgical practice in a data-driven way.
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Affiliation(s)
- Merryn D Constable
- Department of Psychology, Northumbria University, Newcastle-upon-Tyne, UK.
| | - Hubert P H Shum
- Department of Computer Science, Durham University, Durham, UK
| | - Stephen Clark
- Department of Applied Sciences, Northumbria University, Newcastle-upon-Tyne, UK
- Consultant Cardiothoracic and Transplant Surgeon, Freeman Hospital, Newcastle upon Tyne, UK
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Dharanikota H, Wigmore SJ, Skipworth RJE, Yule S. Are multidisciplinary team meetings remotely efficient? Br J Surg 2024; 111:znad429. [PMID: 38198151 PMCID: PMC10782207 DOI: 10.1093/bjs/znad429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/30/2023] [Accepted: 12/05/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Harini Dharanikota
- Edinburgh Surgical Sabermetrics Group, Clinical Surgery, University of Edinburgh, Edinburgh, UK
| | - Stephen J Wigmore
- Edinburgh Surgical Sabermetrics Group, Clinical Surgery, University of Edinburgh, Edinburgh, UK
- Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Richard J E Skipworth
- Edinburgh Surgical Sabermetrics Group, Clinical Surgery, University of Edinburgh, Edinburgh, UK
- Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Steven Yule
- Edinburgh Surgical Sabermetrics Group, Clinical Surgery, University of Edinburgh, Edinburgh, UK
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Mathis MR, Janda AM, Yule SJ, Dias RD, Likosky DS, Pagani FD, Stakich-Alpirez K, Kerray FM, Schultz ML, Fitzgerald D, Sturmer D, Manojlovich M, Krein SL, Caldwell MD. Nontechnical Skills for Intraoperative Team Members. Anesthesiol Clin 2023; 41:803-818. [PMID: 37838385 PMCID: PMC10703542 DOI: 10.1016/j.anclin.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Nontechnical skills, defined as the set of cognitive and social skills used by individuals and teams to reduce error and improve performance in complex systems, have become increasingly recognized as a key contributor to patient safety. Efforts to characterize, quantify, and teach nontechnical skills in the context of perioperative care continue to evolve. This review article summarizes the essential behaviors for safety, described in taxonomies for nontechnical skills assessments developed for intraoperative clinical team members (eg, surgeons, anesthesiologists, scrub practitioners, perfusionists). Furthermore, the authors describe emerging methods to advance understanding of the impact of nontechnical skills on perioperative outcomes.
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Affiliation(s)
- Michael R Mathis
- Department of Anesthesiology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
| | - Allison M Janda
- Department of Anesthesiology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Steven J Yule
- Department of Clinical Surgery, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, Scotland
| | - Roger D Dias
- Department of Emergency Medicine, Brigham & Women's Hospital/Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Donald S Likosky
- Department of Cardiac Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Francis D Pagani
- Department of Cardiac Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Korana Stakich-Alpirez
- Department of Cardiac Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Fiona M Kerray
- Department of Clinical Surgery, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, Scotland
| | - Megan L Schultz
- Department of Cardiac Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - David Fitzgerald
- Department of Clinical Sciences, Medical University of South Carolina College of Health Professions, A 151 Rutledge Avenue, Charleston, SC 29403, USA
| | - David Sturmer
- Department of Perfusion, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Milisa Manojlovich
- School of Nursing, University of Michigan, 426 N Ingalls Street, Ann Arbor, MI 48104, USA
| | - Sarah L Krein
- Department of Internal Medicine, University of Michigan and Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
| | - Matthew D Caldwell
- Department of Anesthesiology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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Gunn EGM, Ambler OC, Nallapati SC, Smink DS, Tambyraja AL, Yule S. Coaching with audiovisual technology in acute-care hospital settings: systematic review. BJS Open 2023; 7:zrad017. [PMID: 37794777 PMCID: PMC10551776 DOI: 10.1093/bjsopen/zrad017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/24/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Surgical coaching programmes are a means of improving surgeon performance. Embedded audiovisual technology has the potential to further enhance participant benefit and scalability of coaching. The objective of this systematic review was to evaluate how audiovisual technology has augmented coaching in the acute-care hospital setting and to characterize its impact on outcomes. METHODS A systematic review was conducted, searching PubMed, Ovid MEDLINE, Embase, PsycInfo, and CINAHL databases using PRISMA. Eligible studies described a coaching programme that utilized audiovisual technology, involved at least one coach-coachee interaction, and included healthcare professionals from the acute-care hospital environment. The risk of bias 2 tool and grading of recommendations, assessment, development, and evaluations (GRADE) framework were used to evaluate studies. Synthesis without meta-analysis was performed, creating harvest plots of three coaching outcomes: technical skills, self-assessment/feedback, and non-technical skills. RESULTS Of 10 458 abstracts screened, 135 full texts were reviewed, and 21 studies identified for inclusion. Seventeen studies were conducted within surgical specialties and six classes of audiovisual technology were utilized. An overall positive direction of effect was demonstrated for studies measuring improvement of either technical skills or non-technical skills. Direction of effect for self-assessment/feedback was weakly positive. CONCLUSION Audiovisual technology has been used successfully in coaching programmes within acute-care hospital settings to facilitate or assess coaching, with a positive impact on outcome measures. Future studies may address the additive benefits of video over in-person observation and enhance the certainty of evidence that coaching impacts on surgeon performance, surgeon well-being, and patient outcomes.
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Affiliation(s)
- Eilidh G M Gunn
- Department of Vascular Surgery, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
| | - Olivia C Ambler
- Department of Vascular Surgery, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Siri C Nallapati
- Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Douglas S Smink
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrew L Tambyraja
- Department of Vascular Surgery, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
| | - Steven Yule
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
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Howie EE, Dharanikota H, Gunn E, Ambler O, Dias R, Wigmore SJ, Skipworth RJE, Yule S. Cognitive Load Management: An Invaluable Tool for Safe and Effective Surgical Training. JOURNAL OF SURGICAL EDUCATION 2023; 80:311-322. [PMID: 36669990 DOI: 10.1016/j.jsurg.2022.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
This article highlights the importance of considering Cognitive Load (CL) and Cognitive Load Theory (CLT) during surgical training, focusing on the acquisition of intra-operative skills. It describes the basis of CLT with the overarching aim of describing CLT-based techniques to enhance current training strategies and surgical performance, many of which are instinctively already employed in surgical practice. Currently, methods of feedback and assessment are imperfect - typically subjective, unsystematic, opportunistic, or retrospective, and at risk of human bias. Surgical Sabermetrics, the advanced analytics of surgical and audio-visual data, aims to enhance this feedback by providing objective, real-time, digital-based feedback. This article introduces the benefit of real-time measurement of CL to enhance feedback and its applications to surgical performance that follow the ethos of Surgical Sabermetrics.1 The 2022 theme for ICOSET was "Making it Better." Cognitive Load and Surgical Sabermetrics principles provide tools to make Surgical training better, with the goal of higher quality care for patients.
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Affiliation(s)
- Emma E Howie
- Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom.
| | | | - Eilidh Gunn
- Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom; Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, United Kingdom
| | - Olivia Ambler
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, United Kingdom; Department of Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Roger Dias
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Stephen J Wigmore
- Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom; Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, United Kingdom
| | - Richard J E Skipworth
- Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom; Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, United Kingdom
| | - Steven Yule
- Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom; Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, United Kingdom; STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts
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Howie E, Wigmore SJ, Daglius Dias R, Skipworth R, Yule S. Protocol for a scoping review on 'surgical sabermetrics:' technology-enhanced measurement of operative non-technical skills. BMJ Open 2023; 13:e064196. [PMID: 36737091 PMCID: PMC9899980 DOI: 10.1136/bmjopen-2022-064196] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Surgeons need high fidelity, high quality, objective, non-judgemental and quantitative feedback to measure their performance in order to optimise their performance and improve patient safety. This can be provided through surgical sabermetrics, defined as 'advanced analytics of digitally recorded surgical training and operative procedures to enhance insight, support professional development and optimise clinical and safety outcomes'. The aim of this scoping review is to investigate the assessment of surgeon's non-technical skills using sabermetrics principles, focusing on digital, automated measurements that do not require a human observer. METHODS AND ANALYSIS To investigate the current methods of digital, automated measurements of surgeons' non-technical skills, a systematic scoping review will be conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, using databases from medicine and other fields. Covidence software is used for screening of potential studies. A data extraction tool will be developed specifically for this study to evaluate the methods of measurement. Quality assurance will be assessed using Quality Assessment Tool for Diverse Designs. Multiple reviewers will be responsible for screening of studies and data extraction. ETHICS AND DISSEMINATION This is a review study, not using primary data, and therefore, ethical approval is not required. A range of methods will be employed for dissemination of the results of this study, including publication in journals and conference presentations.
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Affiliation(s)
- Emma Howie
- Division of Clinical and Surgical Sciences, School of Surgery, The University of Edinburgh, Edinburgh, UK
| | - Stephen J Wigmore
- Division of Clinical and Surgical Sciences, School of Surgery, The University of Edinburgh, Edinburgh, UK
- Department of Surgery, NHS Lothian, Edinburgh, UK
| | - Roger Daglius Dias
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard Skipworth
- Division of Clinical and Surgical Sciences, School of Surgery, The University of Edinburgh, Edinburgh, UK
- Department of Surgery, NHS Lothian, Edinburgh, UK
| | - Steven Yule
- Division of Clinical and Surgical Sciences, School of Surgery, The University of Edinburgh, Edinburgh, UK
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Managing a Team in the Operating Room: The Science of Teamwork and Non-Technical Skills for Surgeons. Curr Probl Surg 2022; 59:101172. [DOI: 10.1016/j.cpsurg.2022.101172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/19/2022]
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