title: Development of workflow task analysis during cerebral diagnostic angiographies: time-based comparison of junior and senior tasks.
abstract: OBJECTIVE
  Assessing neuroradiologists' skills in the operating room (OR) is difficult and often subjective. This study used a workflow time-based task analysis approach while performing cerebral angiography.
  
  
  METHODS
  Eight angiographies performed by a senior neuroradiologist and eight performed by a junior neuroradiologist were compared. Dedicated software with specific terminology was used to record the tasks. Procedures were subdivided into phases, each comprising multiple tasks. Each task was defined as a triplet, associating an action, an instrument and an anatomical structure. The duration of each task was the metric. Total duration of the procedure, task duration and the number of times a task was repeated were identified. The focus was on tasks using fluoroscopy and for moving the X-ray table/tube.
  
  
  RESULTS
  The total duration of tasks to complete the entire procedure was longer for the junior operators than for the seniors (P=0.012). The mean duration per task during the navigation phase was 86s for the juniors and 43s for the seniors (P=0.002). The total and mean durations of tasks involving the use of fluoroscopy were also longer for the juniors (P=0.002 and P=0.033, respectively). For tasks involving the table/tube, the total and mean durations were again longer for the juniors (P=0.019 and P=0.082, respectively).
  
  
  CONCLUSIONS
  This approach allows reliable skill assessment in the radiology OR and comparison of junior and senior competencies during cerebral diagnostic angiography. This new tool can improve the quality and safety of procedures, and facilitate the learning process for neuroradiologists.
authors.affiliation: Department of radiology, Brest university hospital, Brest, France; Inserm, U746, faculty of medicine, Rennes, France; INRIA, VisAGeS Unit/Project, Rennes, France; CNRS, UMR 6074, IRISA, university of Rennes 1, Rennes, France. Electronic address: jcgentric@gmail.com.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gentric
authors.forename: Brivael
authors.initials: B
authors.lastname: Trelhu
authors.forename: Pierre
authors.initials: P
authors.lastname: Jannin
authors.forename: Laurent
authors.initials: L
authors.lastname: Riffaud
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Ferré
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Gauvrit
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010820:Physicians / Q000706:statistics & numerical data; D011361:Professional Competence / Q000706:statistics & numerical data*; D015641:Radiography, Interventional / Q000706:statistics & numerical data*; D013647:Task Performance and Analysis; D013996:Time and Motion Studies; D057188:Workflow; D016526:Workload / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Educational measurement; OR; Professional competence; Surgical process models; Surgical workflow; Systems analysis; operating room