title: Relationship between skill and outcome in the laboratory-based model.
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.
authors.affiliation: Department of Surgical Oncology and Technology, Imperial College School of Medicine at St Mary's, and the Regional Vascular Unit, St Mary's Hospital, London, UK.
authors.forename: Vivek
authors.initials: V
authors.lastname: Datta
authors.forename: Mirren
authors.initials: M
authors.lastname: Mandalia
authors.forename: Sean
authors.initials: S
authors.lastname: Mackay
authors.forename: Avril
authors.initials: A
authors.lastname: Chang
authors.forename: Nicholas
authors.initials: N
authors.lastname: Cheshire
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002983:Clinical Competence; D006801:Humans; D008955:Models, Cardiovascular; D009048:Motor Skills; D011138:Polytetrafluoroethylene; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene