title: Surgical Skill Assessment Using Motion Quality and Smoothness.
abstract: OBJECTIVE
  This article presents a quantitative technique to assess motion quality and smoothness during the performance of micromanipulation tasks common to surgical maneuvers. The objective is to investigate the effectiveness of the jerk index, a derivative of acceleration with respect to time, as a kinetostatic measure for assessment of surgical performance.
  
  
  METHODS
  A surgical forceps was instrumented with a position tracker and accelerometer that allowed measurement of position and acceleration relative to tool motion. Participants were asked to perform peg-in-hole tasks on a modified O'Connor Dexterity board and a Tweezer Dexterity pegboard (placed inside a skull). Normalized jerk index was calculated for each individual task to compare smoothness of each group.
  
  
  METHODS
  This study was conducted at Project neuroArm, Cumming School of Medicine, the University of Calgary.
  
  
  METHODS
  Four groups of participants (surgeons, surgery residents, engineers, and gamers) participated in the tests.
  
  
  RESULTS
  Results showed that the surgeons exhibited better jerk index performance in all tasks. Moreover, the residents experienced motions closer to the surgeons compared to the engineers and gamers. One-way analysis of variance test indicated a significant difference between the mean values of normalized jerk indices among 4 groups during the performance of all tasks. Moreover, the mean value of the normalized jerk index significantly varied for each group from one task to another.
  
  
  CONCLUSIONS
  Normalized jerk index as an independent parameter with respect to time and amplitude is an indicator of motion smoothness and can be used to assess hand motion dexterity of surgeons. Furthermore, the method provides a quantifiable metrics for trainee assessment and proficiency, particularly relevant as surgical training shifts toward a competency-based paradigm.
authors: Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Surgery, Arnie Charbonneau Cancer Institute, Section of Otolaryngology-Head & Neck Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Ahmad
authors: A
authors: Ghasemloonia
authors: Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Yaser
authors: Y
authors: Maddahi
authors: Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Kourosh
authors: K
authors: Zareinia
authors: Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Sanju
authors: S
authors: Lama
authors: Department of Surgery, Arnie Charbonneau Cancer Institute, Section of Otolaryngology-Head & Neck Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors: Joseph C
authors: JC
authors: Dort
authors: Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: garnette@ucalgary.ca.
authors: Garnette R
authors: GR
authors: Sutherland
mesh_terms: D000054:Acceleration; D000704:Analysis of Variance; D013502:General Surgery / Q000193:education*; D006801:Humans; D017145:Models, Educational; D009038:Motion; D009048:Motor Skills; D018794:Problem-Based Learning / Q000379:methods*; D011786:Quality Control; D013525:Surgical Instruments; D013514:Surgical Procedures, Operative / Q000193:education; D013647:Task Performance and Analysis
keywords: Medical Knowledge; Practice-Based Learning and Improvement; acceleration; dexterity; jerk index; motion; smoothness; surgical skill