Background
From the clinical point of view, it is important to recognize residents’ level of expertise with regard to basic psychomotor
skills. For that reason, surgeons and surgical organizations (e.g., Acreditation Council for Graduate Medical Education, ACGME)
are calling for assessment tools that credential residents as technically competent. Currently, no method is universally accepted
or recommended for classifying residents as “experienced,” “intermediates,” or “novices” according to their technical abilities.
This study introduces a classification method for recognizing residents’ level of experience in laparoscopic surgery based
on psychomotor laparoscopic skills alone.
Methods
For this study, 10 experienced residents (>100 laparoscopic procedures performed), 10 intermediates (10–100 procedures performed),
and 11 novices (no experience) performed four tasks in a box trainer. The movements of the laparoscopic instruments were recorded
with the TrEndo tracking system and analyzed using six motion analysis parameters (MAPs). The MAPs of all participants were
submitted to principal component analysis (PCA), a data reduction technique. The scores of the first principal components
were used to perform linear discriminant analysis (LDA), a classification method. Performance of the LDA was examined using
a leave-one-out cross-validation.
Results
Of 31 participants, 23 were classified correctly with the proposed method, with 7 categorized as experienced, 7 as intermediates,
and 9 as novices.
Conclusions
The proposed method provides a means to classify residents objectively as experienced, intermediate, or novice surgeons according
to their basic laparoscopic skills. Due to the simplicity and generalizability of the introduced classification method, it
is easy to implement in existing trainers.
Keywords Assessment - Classification - Minimally invasive surgery - Motion analysis - Training