title: Evaluation of Simulated Clinical Breast Exam Motion Patterns Using Marker-Less Video Tracking.
abstract: OBJECTIVE
  This study investigates using marker-less video tracking to evaluate hands-on clinical skills during simulated clinical breast examinations (CBEs).
  
  
  BACKGROUND
  There are currently no standardized and widely accepted CBE screening techniques.
  
  
  METHODS
  Experienced physicians attending a national conference conducted simulated CBEs presenting different pathologies with distinct tumorous lesions. Single hand exam motion was recorded and analyzed using marker-less video tracking. Four kinematic measures were developed to describe temporal (time pressing and time searching) and spatial (area covered and distance explored) patterns.
  
  
  RESULTS
  Mean differences between time pressing, area covered, and distance explored varied across the simulated lesions. Exams were objectively categorized as either sporadic, localized, thorough, or efficient for both temporal and spatial categories based on spatiotemporal characteristics. The majority of trials were temporally or spatially thorough (78% and 91%), exhibiting proportionally greater time pressing and time searching (temporally thorough) and greater area probed with greater distance explored (spatially thorough). More efficient exams exhibited proportionally more time pressing with less time searching (temporally efficient) and greater area probed with less distance explored (spatially efficient). Just two (5.9 %) of the trials exhibited both high temporal and spatial efficiency.
  
  
  CONCLUSIONS
  Marker-less video tracking was used to discriminate different examination techniques and measure when an exam changes from general searching to specific probing. The majority of participants exhibited more thorough than efficient patterns.
  
  
  CONCLUSIONS
  Marker-less video kinematic tracking may be useful for quantifying clinical skills for training and assessment.
authors.affiliation: University of Wisconsin-Madison, Madison, WI.
authors.forename: David P
authors.initials: DP
authors.lastname: Azari
authors.affiliation: University of Wisconsin-Madison, Madison, WI.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Pugh
authors.affiliation: University of Wisconsin-Madison, Madison, WI.
authors.forename: Shlomi
authors.initials: S
authors.lastname: Laufer
authors.affiliation: University of Wisconsin-Madison, Madison, WI.
authors.forename: Calvin
authors.initials: C
authors.lastname: Kwan
authors.affiliation: University of Wisconsin-Madison, Madison, WI.
authors.forename: Chia-Hsiung
authors.initials: CH
authors.lastname: Chen
authors.affiliation: University of Wisconsin-Madison, Madison, WI.
authors.forename: Thomas Y
authors.initials: TY
authors.lastname: Yen
authors.affiliation: University of Wisconsin-Madison, Madison, WI.
authors.forename: Yu Hen
authors.initials: YH
authors.lastname: Hu
authors.affiliation: University of Wisconsin-Madison, Madison, WI radwin@discovery.wisc.edu.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Radwin
mesh_terms: D000465:Algorithms; D001940:Breast / Q000000981:diagnostic imaging*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008962:Models, Theoretical; D010808:Physical Examination / Q000379:methods*; D014741:Video Recording / Q000379:methods*
keywords: examination technique; hands-on clinical examination; medical simulation; tactile inspection