title: Quantitative pediatric surgical skill assessment using a rapid-prototyped chest model.
abstract: BACKGROUND
  Though minimally invasive pediatric surgery has become more widespread, pediatric-specific surgical skills have not been quantitatively assessed.
  
  
  METHODS
  As a first step toward the quantification of pediatric-specific surgical skills, a pediatric chest model comprising a three-dimensional rapid-prototyped pediatric ribcage with accurate anatomical dimensions, a suturing skin model with force-sensing capability, and forceps with motion-tracking sensors were developed. A skill assessment experiment was conducted by recruiting 16 inexperienced pediatric surgeons and 14 experienced pediatric surgeons to perform an endoscopic intracorporeal suturing and knot-tying task in both the pediatric chest model setup and the conventional box trainer setup.
  
  
  RESULTS
  The instrument motion measurement was successful in only 20 surgeons due to sensor failure. The task completion time, total path length of instruments, and applied force were compared between the inexperienced and experienced surgeons as well as between the box trainer and chest model setups. The experienced surgeons demonstrated better performance in all parameters for both setups, and the pediatric chest model was more challenging due to the pediatric features replicated by the model.
  
  
  CONCLUSIONS
  The pediatric chest model was valid for pediatric skill assessment, and further analysis of the collected data will be conducted to further investigate pediatric-specific skills.
authors.affiliation: School of Engineering, The University of Tokyo , Tokyo , Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Harada
authors.forename: Shinya
authors.initials: S
authors.lastname: Takazawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tsukuda
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishimaru
authors.forename: Naohiko
authors.initials: N
authors.lastname: Sugita
authors.forename: Tadashi
authors.initials: T
authors.lastname: Iwanaka
authors.forename: Mamoru
authors.initials: M
authors.lastname: Mitsuishi
mesh_terms: D002983:Clinical Competence; D006801:Humans; D010372:Pediatrics / Q000193:education* / Q000592:standards; D000066908:Simulation Training; D013536:Suture Techniques / Q000193:education* / Q000592:standards; D013906:Thoracoscopy / Q000193:education* / Q000592:standards
keywords: Pediatric; minimally invasive surgery; model; simulation; skill assessment