title: A hierarchical task analysis of cricothyroidotomy procedure for a virtual airway skills trainer simulator.
abstract: BACKGROUND
  Despite the critical importance of cricothyroidotomy (CCT) for patient in extremis, clinical experience with CCT is infrequent, and current training tools are inadequate. The long-term goal is to develop a virtual airway skills trainer that requires a thorough task analysis to determine the critical procedural steps, learning metrics, and parameters for assessment.
  
  
  METHODS
  Hierarchical task analysis is performed to describe major tasks and subtasks for CCT. A rubric for performance scoring for each task was derived, and possible operative errors were identified.
  
  
  RESULTS
  Time series analyses for 7 CCT videos were performed with 3 different observers. According to Pearson's correlation tests, 3 of the 7 major tasks had a strong correlation between their task times and performance scores.
  
  
  CONCLUSIONS
  The task analysis forms the core of a proposed virtual CCT simulator, and highlights links between performance time and accuracy when teaching individual surgical steps of the procedure.
authors.affiliation: Computer Science Department, University of Central Arkansas, 201 Donaghey Avenue, Conway, AR, 72035, USA.
authors.forename: Doga
authors.initials: D
authors.lastname: Demirel
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard School of Medicine, Boston, MA, USA.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Butler
authors.affiliation: Computer Science Department, University of Central Arkansas, 201 Donaghey Avenue, Conway, AR, 72035, USA. Electronic address: tanselh@uca.edu.
authors.forename: Tansel
authors.initials: T
authors.lastname: Halic
authors.affiliation: Department of Mechanical, Aerospace, and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Sankaranarayanan
authors.affiliation: Department of Biomedical, Industrial, and Human Factors Engineering, Wright State University, Dayton, OH, USA.
authors.forename: David
authors.initials: D
authors.lastname: Spindler
authors.affiliation: Department of Biomedical, Industrial, and Human Factors Engineering, Wright State University, Dayton, OH, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Cao
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard School of Medicine, Boston, MA, USA.
authors.forename: Emil
authors.initials: E
authors.lastname: Petrusa
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Harvard School of Medicine, Boston, MA, USA.
authors.forename: Marcos
authors.initials: M
authors.lastname: Molina
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Harvard School of Medicine, Boston, MA, USA.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Jones
authors.affiliation: Department of Mechanical, Aerospace, and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA.
authors.forename: Suvranu
authors.initials: S
authors.lastname: De
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard School of Medicine, Boston, MA, USA.
authors.forename: Marc A
authors.initials: MA
authors.lastname: deMoya
mesh_terms: D058109:Airway Management / Q000379:methods*; D002983:Clinical Competence; D003198:Computer Simulation; D003413:Cricoid Cartilage / Q000601:surgery*; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D010036:Otolaryngology / Q000193:education*; D013647:Task Performance and Analysis; D014584:User-Computer Interface
keywords: Cricothyroidotomy; Cricothyroidotomy simulator; Surgical education; Surgical simulator