title: High-fidelity, low-cost, automated method to assess laparoscopic skills objectively.
abstract: BACKGROUND
  We sought to define the extent to which a motion analysis-based assessment system constructed with simple equipment could measure technical skill objectively and quantitatively.
  
  
  METHODS
  An "off-the-shelf" digital video system was used to capture the hand and instrument movement of surgical trainees (beginner level = PGY-1, intermediate level = PGY-3, and advanced level = PGY-5/fellows) while they performed a peg transfer exercise. The video data were passed through a custom computer vision algorithm that analyzed incoming pixels to measure movement smoothness objectively.
  
  
  RESULTS
  The beginner-level group had the poorest performance, whereas those in the advanced group generated the highest scores. Intermediate-level trainees scored significantly (p < 0.04) better than beginner trainees. Advanced-level trainees scored significantly better than intermediate-level trainees and beginner-level trainees (p < 0.04 and p < 0.03, respectively).
  
  
  CONCLUSIONS
  A computer vision-based analysis of surgical movements provides an objective basis for technical expertise-level analysis with construct validity. The technology to capture the data is simple, low cost, and readily available, and it obviates the need for expert human assessment in this setting.
authors.affiliation: Department of Surgery, Mayo Clinic, Scottsdale, Arizona 85259, USA. gray.richard@mayo.edu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gray
authors.forename: Kanav
authors.initials: K
authors.lastname: Kahol
authors.forename: Gazi
authors.initials: G
authors.lastname: Islam
authors.forename: Marshall
authors.initials: M
authors.lastname: Smith
authors.forename: Alyssa
authors.initials: A
authors.lastname: Chapital
authors.forename: John
authors.initials: J
authors.lastname: Ferrara
mesh_terms: D000328:Adult; D001130:Arizona; D001331:Automation / Q000191:economics / Q000379:methods; D002983:Clinical Competence; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000191:economics / Q000379:methods*; D004521:Educational Measurement; D005069:Evaluation Studies as Topic; D005260:Female; D013502:General Surgery / Q000191:economics / Q000193:education; D006801:Humans; D007396:Internship and Residency / Q000191:economics / Q000379:methods; D010535:Laparoscopy / Q000191:economics / Q000193:education*; D008297:Male; D018794:Problem-Based Learning; D011597:Psychomotor Performance; D014741:Video Recording / Q000191:economics / Q000706:statistics & numerical data*