eoSurgical pioneered accessible instrument tracking technology and we’re learning more and more about what this data means. As one performs a task from our curriculum, the movement of the instruments is captured and measured. This tracking data is then converted into a set of performance metrics. As well as giving users the raw data, we translate it into natural language feedback to accelerate improvement. There is good evidence validating motion analysis for laparoscopic skills training. All metrics are automatically uploaded to a cloud-based portfolio, generating an online record of progression (to complement the e-logbook and, for UK-based trainees, the ISCP record of training).
What do the metrics mean?
Time: The less time it takes to complete a task, the more efficient you have been. However, precision shouldn't be traded for speed and the other metrics help to draw out this detail. The three target times for each module have been set by experts able to complete each task with both precision and speed.
Instrument Path Distance: This is a measure of the precision of control of the instruments. Experts are able to complete modules with a significantly lower instrument path distance than trainees.
Handedness/Ambidexterity: Experts utilise both hands equally to complete surgical tasks - i.e. they exhibit a degree of ambidexterity. Most of us are right-hand dominant and trainees should aim for a ratio of at least 65:35% (dominant:non-dominant hand) when training.
% Time off screen: Keeping the instruments within the operative field is a key skill in minimally invasive surgery. Aim to keep this figure as low as possible for all tasks.
Distance between instruments: This is a measure of 'economy of area'. The lower this figure, the closer the control of your instruments and the less they have been moving around without purpose.
Speed, Acceleration & Motion Smoothness: We are working to understand how these metrics relate to training and performance. If you are interested or want to get involved in this research, get in touch.
Lastly, if motivation is needed, trainees can see how they measure up in TopScalpel. This is an opt-in feature that allows individuals to compete and compare performance with their peers via our global online leaderboard: TopScalpel. There are now over 41,000 recorded activities with trainees from across the globe practising every day to get better. It's time to join them!
Mark Hughes
Director, eoSurgical & Clinical Lecturer in Neurosurgery, University of Edinburgh
@eosurgical