The hands and head of a surgeon: Modeling operative competency with multimodal epistemic network analysis
| Autor: | A. R. Ruis, Jay N. Nathwani, Cheyenne Quandt-Walle, Carla M. Pugh, Alexandra A. Rosser, David Williamson Shaffer |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Intraoperative Period 03 medical and health sciences 0302 clinical medicine Humans Medicine 030212 general & internal medicine Cognitive skill Simulation Training Herniorrhaphy Surgeons Psychomotor learning Medical Errors business.industry Ventral hernia repair 05 social sciences Internship and Residency 050301 education Cognition General Medicine Hernia Ventral Checklist Epistemology Education Medical Graduate Error Management Female Laparoscopy Surgery Clinical Competence business 0503 education Network analysis |
| Zdroj: | The American Journal of Surgery. 216:835-840 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2017.11.027 |
| Popis: | Background This paper explores a method for assessing intraoperative performance by modeling how surgeons integrate psychomotor, procedural, and cognitive skills to manage errors. Methods Audio-video data were collected from general surgery residents (N = 45) performing a simulated laparoscopic ventral hernia repair. Errors were identified using a standard checklist, and speech was coded for elements related to error recognition and management. Epistemic network analysis (ENA) was used to model the integration of error management skills. Results There was no correlation between number or type of errors committed and operative outcome. However, ENA models showed significant differences in the integration of error management skills between high-performing and low-performing residents. Conclusion These results suggest that error checklists and surgeons' speech can be used to model the integration of psychomotor, procedural, and cognitive aspects of intraoperative performance. Moreover, ENA can identify and quantify this integration, providing insight on performance gaps in both individuals and populations. |
| Databáze: | OpenAIRE |
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