The advent of the Internet followed by the diffusion of Web 2.0 has the potential to revolutioniz... more The advent of the Internet followed by the diffusion of Web 2.0 has the potential to revolutionize the delivery of clinical training in healthcare in both remote and urban clinical environments [1-4]. This is of significant relevance to the military given the shortage of healthcare providers and the remote locations in which the military has to operate. The objective of this proposal was to design, develop and evaluate a socially relevant knowledge driven collaborative training network. The scope of the project included non-collocated distributed clinical teams solving medical decision making problems with the help of Web 3.0 tools. We developed the collaborative virtual environments and defined clinical team activities for which the virtual worlds were used. Three different training modalities were utilized; traditional training, virtual training with persuasive techniques, and virtual training without persuasive techniques. Focusing on Advanced Cardiac Life Support training, we developed a virtual world platform to enable training of disparate teams on ACLS training, and then were tested on developed clinical scenarios. Then by coupling haptic devices with the virtual world, we enabled a multisensorial platform for team training. The preliminary results shows the validity of the collaborative virtual environment with persuasive techniques to address needs of clinical training as well as current methodologies and sets the stage for further evaluation of this approach. 15. SUBJECT TERMS Training for Collaborative Decision Making, Virtual Worlds, Web 3.0 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU 18. NUMBER OF PAGES 29 19a. NAME OF RESPONSIBLE PERSON
Advances in the medical field have increased the need to incorporate modern techniques into surgi... more Advances in the medical field have increased the need to incorporate modern techniques into surgical resident training and surgical skills learning. To facilitate this integration, one approach that has gained credibility is the incorporation of simulator based training to supplement traditional training programs. However, existing implementations of these training methods still require the constant presence of a competent surgeon to assess the surgical dexterity of the trainee, which limits the evaluation methods and relies on subjective evaluation. This research proposes an efficient, effective, and economic video-based skill assessment technique for minimally invasive surgery (MIS). It analyzes a surgeon's hand and surgical tool movements and detects features like smoothness, efficiency, and preciseness. The system is capable of providing both real time on-screen feedback and a performance score at the end of the surgery. Finally, we present a web-based tool where surgeons ca...
Feedback in surgical simulation has been limited to offline analysis of movement, time taken to c... more Feedback in surgical simulation has been limited to offline analysis of movement, time taken to complete simulation and in some cases a virtual playback of completed simulation tasks. In comparison to aircraft simulation, these feedback schemes are very rudimentary. Research in military simulations has shown that real time feedback significantly improves performance on the task at hand and leads to skill generalization and transfer. However, such systems have not been developed for surgical simulation. Lack of effective feedback systems also has the added effect of increasing workload of senior surgeons leading to increased costs and decreased overall efficiency. In a pilot study performed with 8 surgical residents, we tested the effect of real time feedback on movement proficiency.
Color is inaccessible for individuals who are blind or visually impaired, as it is a purely visua... more Color is inaccessible for individuals who are blind or visually impaired, as it is a purely visual feature. Given that many everyday tasks rely on color including coordinating clothing, social interactions, etc., the inaccessibility of color has an adverse effect on daily life. We propose an interactive, wearable assistive device that can recognize and convey colors of scenes or objects. As computer vision is challenging in real world environments due to, eg, illumination or pose changes, computer vision algorithms can be augmented with sub-systems that ...
2013 IEEE International Conference on Multimedia and Expo Workshops (ICMEW), 2013
Advances in the medical field require new and progressive ways to intensify surgical resident tra... more Advances in the medical field require new and progressive ways to intensify surgical resident training and surgical skills learning. To address this need, in addition to traditional training using realistic surgical objects, simulator-based training programs have been widely adopted. Both training methods need constant presence of a competent surgeon to assess the surgical dexterity of a trainee, which is not only costly but also very subjective. This paper proposes a novel video-based approach for assessing the trainee's hand and tool movements in minimally invasive surgical training. Videos capturing surgical training actions are analysed to automatically extract major skill measuring features and to provide real-time performance feedback to the trainee. The method has the potential of being extended to skill evaluation in real surgeries at low cost.
The health care industry faces a number of challenges and arguably one of the most important ones... more The health care industry faces a number of challenges and arguably one of the most important ones lies in maintaining high levels of patient safety. A much-cited report released by the Institute of Medicine [1] estimates that as many as 98,000 people die each year due to medical errors [1]. The causal determinants of these errors can be traced to a variety of medical, cognitive and social challenges in the clinical workplace. These challenges are exacerbated in critical care environments that are characterized by distributed, interdependent, episodic and non-linear work activities. The dynamic nature of the care process in critical care environment affects the nature and timing of work activities of clinicians, and often increases the possibility of errors. Studying the work activities of clinicians in such environments can help in understanding the care delivery process, workflow, and interruptions that affect clinical work.
2006 IEEE International Workshop on Haptic Audio Visual Environments and their Applications (HAVE 2006), 2006
Abstract In haptic environments, it is especially demanding to design realistic interaction parad... more Abstract In haptic environments, it is especially demanding to design realistic interaction paradigms and provide global navigational cues. In this paper, we present a methodology that can replace and/or augment realistic haptic environments and is inspired by the psychological basis of haptics. The system employs haptic cueing to convey information about shape, size, texture, and material of the object through user-determined cues. The key conceptual framework that guides this approach is that humans have haptical memory of ...
7th International Conference on Broadband Communications and Biomedical Applications, 2011
Advances in the medical field have introduced new and progressive ways to intensify surgical resi... more Advances in the medical field have introduced new and progressive ways to intensify surgical resident training and surgical skills learning by developing systematic simulator training programs alongside traditional training. Both training methods need constant presence of a competent surgeon to subjectively assess the surgical dexterity of the trainee. Several studies have been conducted to measure user's skill objectively and quantitatively,
Proceedings 2003 International Conference on Image Processing (Cat. No.03CH37429)
Complex human motion sequences (such as dances) are typically analyzed by segmenting !hem into sh... more Complex human motion sequences (such as dances) are typically analyzed by segmenting !hem into shorter motion sequences, called geslures. However, this segmentation process is subjective, and varies considerably from one human observer to another. In this paper, we propose an algorithm called Hierarchical Aclivig Segmentation. This algorithm employs a dynamic hierarchical layered StNcNre to represent the human anatomy, and uses low-level motion parameters to characterize motion in the various layers ofthis hierarchy, which copespond to different segments of thc human body. This characterization is used with a narve Bayesian classifier to derive creator prqfiles from empirical data. Then those profiles are used to predict how creators will segment gestures in other motion sequences. When the predictions were tested with a library of 3D motion capture sequences, which were segmented by 2 choreographers they were found to be reasanably accurate.
This paper proposes design, development and testing of an assistive device for distal environment... more This paper proposes design, development and testing of an assistive device for distal environment perception for individuals who are blind through a haptic user interface (touch-based interface).
18th International Conference on Pattern Recognition (ICPR'06), 2006
Abstract Humans are adept at size classification from visual images of objects. A challenging com... more Abstract Humans are adept at size classification from visual images of objects. A challenging computer vision problem is that of automatic visual size classification. Current size classification systems assume controlled environments and use features geared towards a particular object category and pose. However, certain applications may require algorithms that can adapt to a variety of object categories and handle complex environments. In this paper, we propose a Bayesian approach to automatic visual size classification, inspired ...
Proceedings of the First International Conference on Ambient Media and Systems, 2008
Abstract Over the last few years, Radio-Frequency Identification (RFID) technology has gained pop... more Abstract Over the last few years, Radio-Frequency Identification (RFID) technology has gained popularity for use in assistive technology for individuals who are blind. Recently, RFID-based wearable assistive devices have been developed for individuals who are blind to assist with navigation or remote object perception. However, RFID-based assistive technology suffers from two major drawbacks:(1) information overload in environments with many tagged objects, and (2) usability issues in untagged environments. In this paper, we ...
2008 IEEE International Workshop on Haptic Audio visual Environments and Games, 2008
An issue that complicates movement training, specifically in minimally invasive surgery, is that ... more An issue that complicates movement training, specifically in minimally invasive surgery, is that often there is no one to one correlation between the visual feedback provided on a screen and the movement required to perform the given task. This paper presents a simulator that specifically addresses the intermodal conflict between motor actuation and visual feedback. We developed a virtual reality visio-haptic simulator to assist surgical residents in training to resolve visio-motor conflict. The developed simulator offers individuals the flexibility to train in various scenarios with different levels of visio-motor conflicts. The levels of conflict were simulated by creating a linear functional relation between movement in the real environment and the virtual environment. The haptic rendering was consistent with the visual feedback. Experiments were conducted with expert pediatric surgeons and general surgery residents. Baseline data on performance in conditions of visio-motor conflict were assimilated from expert surgeons. Residents were divided into experimental group that was exposed to visio-motor conflict and the control group which wasn't exposed to visio-motor conflict training. When the performance was compared on a standard surgical suturing task, the residents with intermodal conflict training performed better than the control group suggesting the construct validity of the training and that visio-motor training can accelerate learning.
Proceedings of the 14th annual ACM international conference on Multimedia - MULTIMEDIA '06, 2006
Abstract Surgical movement is composed of discrete gestures that are combined to perform complex ... more Abstract Surgical movement is composed of discrete gestures that are combined to perform complex surgical procedures. A promising approach to objective surgical skill evaluation systems is kinematics and kinetic analysis of hand movement that yields a gesture level analysis of proficiency of a performed movement. In this paper, we propose a novel system that combines surgical gesture segmentation, surgical gesture recognition, and expertise analysis of surgical profiles in minimally invasive surgery (MIS). Kinematic analysis was ...
Surgical residents are exposed to a significant amount of cognitive load during call. While vario... more Surgical residents are exposed to a significant amount of cognitive load during call. While various efforts have been made to quantify the effect of fatigue and sleep deprivation on the psychomotor skills of surgical residents, there is very little investigations into the effect of these factors on cognitive skills. However, this is an important issue in medical curriculum design, as much of the medical errors are procedural in nature and are not psychomotor. In this paper, we present a study that aimed to quantify the effect of fatigue on cognitive skills. We employed hand movement data for developing a proficiency measure of surgical skill. The difference in proficiencies measured through hand movement post call and pre call was determined. The simulation tasks were designed to challenge working memory, attention of the user. The results showed a significant difference in hand movement proficiencies as well as behavioral errors pre and post-call. EEG Data was also gathered during simulation tasks pre and post call through the B-Alert® Bluetooth EEG technology. The B-Alert® software was analyzed to reveal ratings of alertness/drowsiness, engagement, mental workload and distraction. The results showed statistically significant difference in EEG ratings in pre call and post call condition.
BACKGROUND: Fatigue and sleep deprivation and their effects on surgical proficiency have been act... more BACKGROUND: Fatigue and sleep deprivation and their effects on surgical proficiency have been actively researched areas. Past studies that have focused solely on residents have provided an important insight into how fatigue affects residents' ability to perform. This study aims to quantify the effect of fatigue on attending surgeons. METHODS: To quantify the effect of fatigue on psychomotor and cognitive skills of surgical residents and attending surgeons, visiohaptic simulations were created to mimic realistic interactions. RESULTS: Both groups showed a significant decrement in proficiency measures postcall. When tasks were separated based on psychomotor versus cognitive-dominated skills, attending surgeons made 25% fewer (P Ͻ .05) cognitive errors than residents postcall. Psychomotor skills were equally affected in both groups. CONCLUSIONS: Call-associated fatigue is associated with increased error rates in the cognitive skill domain, although less so in attending surgeons compared with their resident counterparts.
BACKGROUND: Surgery training requires residents to focus on tasks while minimizing the effect of ... more BACKGROUND: Surgery training requires residents to focus on tasks while minimizing the effect of distractions. There is a need to develop training methodologies that can enable surgical residents to hone this ability. METHODS: Fourteen surgical residents were divided into 2 groups. They were trained to perform simulated tasks in a noiseless environment and subsequently performed these tasks in a distractive one. In a follow-up experiment, an experimental group was trained in noisy and distractive conditions and was compared with a control group trained in noiseless conditions. RESULTS: Residents who trained in noiseless environments possessed decreased surgical proficiency when performing the identical tasks in realistic environments (P Ͻ .05). Pretraining in a noisy environment improves surgical proficiency. CONCLUSIONS: Noise and distractions can significantly impede performance of surgical residents, but this effect can be nullified by introduction of noise and distractions in the training environment.
BACKGROUND: It is unknown whether surgical residents who learn minimal-access surgery skills in a... more BACKGROUND: It is unknown whether surgical residents who learn minimal-access surgery skills in an unstructured environment (ie, at home), will develop a technical skill set that rivals that of those trained in the more traditional, structured learning environment. METHODS: Seven surgery residents were provided structured learning through didactic and hands-on skills training sessions and consistent supervision throughout training. A second group of 7 residents participated in an unstructured learning curriculum of training without supervision. End points were determined at the end of training using a standardized simulator based on predetermined performance measures. RESULTS: Both groups achieved high task scores, with comparable scores on gesture proficiency, hand movement smoothness, instrument movement smoothness, errors, and time elapsed. There was no significant difference between group differences in final skills scores. CONCLUSIONS: Unstructured learning is equally effective in delivering quality skills training when compared with structured training.
BACKGROUND: Although surgeons perform procedures and tasks under a significant amount of cognitiv... more BACKGROUND: Although surgeons perform procedures and tasks under a significant amount of cognitive load, current simulators focus on training psychomotor skills in isolation. This may limit the transfer of learned skills to actual surgical environments. METHODS: Visuohaptic simulations were created that required participants to hone psychomotor skills in the presence of cognitive load. A control group (n ϭ 7) trained on conventional skills simulator and their performance was compared with the experimental group (n ϭ 7) in terms of learning curves and performance on a transfer task. RESULTS: The experimental group performed significantly better than the control group in terms of both learning curves and performance on the transfer task. CONCLUSIONS: Simulations that combine psychomotor and cognitive skills training are more effective than simulators that focus on psychomotor skills in isolation.
The advent of the Internet followed by the diffusion of Web 2.0 has the potential to revolutioniz... more The advent of the Internet followed by the diffusion of Web 2.0 has the potential to revolutionize the delivery of clinical training in healthcare in both remote and urban clinical environments [1-4]. This is of significant relevance to the military given the shortage of healthcare providers and the remote locations in which the military has to operate. The objective of this proposal was to design, develop and evaluate a socially relevant knowledge driven collaborative training network. The scope of the project included non-collocated distributed clinical teams solving medical decision making problems with the help of Web 3.0 tools. We developed the collaborative virtual environments and defined clinical team activities for which the virtual worlds were used. Three different training modalities were utilized; traditional training, virtual training with persuasive techniques, and virtual training without persuasive techniques. Focusing on Advanced Cardiac Life Support training, we developed a virtual world platform to enable training of disparate teams on ACLS training, and then were tested on developed clinical scenarios. Then by coupling haptic devices with the virtual world, we enabled a multisensorial platform for team training. The preliminary results shows the validity of the collaborative virtual environment with persuasive techniques to address needs of clinical training as well as current methodologies and sets the stage for further evaluation of this approach. 15. SUBJECT TERMS Training for Collaborative Decision Making, Virtual Worlds, Web 3.0 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU 18. NUMBER OF PAGES 29 19a. NAME OF RESPONSIBLE PERSON
Advances in the medical field have increased the need to incorporate modern techniques into surgi... more Advances in the medical field have increased the need to incorporate modern techniques into surgical resident training and surgical skills learning. To facilitate this integration, one approach that has gained credibility is the incorporation of simulator based training to supplement traditional training programs. However, existing implementations of these training methods still require the constant presence of a competent surgeon to assess the surgical dexterity of the trainee, which limits the evaluation methods and relies on subjective evaluation. This research proposes an efficient, effective, and economic video-based skill assessment technique for minimally invasive surgery (MIS). It analyzes a surgeon's hand and surgical tool movements and detects features like smoothness, efficiency, and preciseness. The system is capable of providing both real time on-screen feedback and a performance score at the end of the surgery. Finally, we present a web-based tool where surgeons ca...
Feedback in surgical simulation has been limited to offline analysis of movement, time taken to c... more Feedback in surgical simulation has been limited to offline analysis of movement, time taken to complete simulation and in some cases a virtual playback of completed simulation tasks. In comparison to aircraft simulation, these feedback schemes are very rudimentary. Research in military simulations has shown that real time feedback significantly improves performance on the task at hand and leads to skill generalization and transfer. However, such systems have not been developed for surgical simulation. Lack of effective feedback systems also has the added effect of increasing workload of senior surgeons leading to increased costs and decreased overall efficiency. In a pilot study performed with 8 surgical residents, we tested the effect of real time feedback on movement proficiency.
Color is inaccessible for individuals who are blind or visually impaired, as it is a purely visua... more Color is inaccessible for individuals who are blind or visually impaired, as it is a purely visual feature. Given that many everyday tasks rely on color including coordinating clothing, social interactions, etc., the inaccessibility of color has an adverse effect on daily life. We propose an interactive, wearable assistive device that can recognize and convey colors of scenes or objects. As computer vision is challenging in real world environments due to, eg, illumination or pose changes, computer vision algorithms can be augmented with sub-systems that ...
2013 IEEE International Conference on Multimedia and Expo Workshops (ICMEW), 2013
Advances in the medical field require new and progressive ways to intensify surgical resident tra... more Advances in the medical field require new and progressive ways to intensify surgical resident training and surgical skills learning. To address this need, in addition to traditional training using realistic surgical objects, simulator-based training programs have been widely adopted. Both training methods need constant presence of a competent surgeon to assess the surgical dexterity of a trainee, which is not only costly but also very subjective. This paper proposes a novel video-based approach for assessing the trainee's hand and tool movements in minimally invasive surgical training. Videos capturing surgical training actions are analysed to automatically extract major skill measuring features and to provide real-time performance feedback to the trainee. The method has the potential of being extended to skill evaluation in real surgeries at low cost.
The health care industry faces a number of challenges and arguably one of the most important ones... more The health care industry faces a number of challenges and arguably one of the most important ones lies in maintaining high levels of patient safety. A much-cited report released by the Institute of Medicine [1] estimates that as many as 98,000 people die each year due to medical errors [1]. The causal determinants of these errors can be traced to a variety of medical, cognitive and social challenges in the clinical workplace. These challenges are exacerbated in critical care environments that are characterized by distributed, interdependent, episodic and non-linear work activities. The dynamic nature of the care process in critical care environment affects the nature and timing of work activities of clinicians, and often increases the possibility of errors. Studying the work activities of clinicians in such environments can help in understanding the care delivery process, workflow, and interruptions that affect clinical work.
2006 IEEE International Workshop on Haptic Audio Visual Environments and their Applications (HAVE 2006), 2006
Abstract In haptic environments, it is especially demanding to design realistic interaction parad... more Abstract In haptic environments, it is especially demanding to design realistic interaction paradigms and provide global navigational cues. In this paper, we present a methodology that can replace and/or augment realistic haptic environments and is inspired by the psychological basis of haptics. The system employs haptic cueing to convey information about shape, size, texture, and material of the object through user-determined cues. The key conceptual framework that guides this approach is that humans have haptical memory of ...
7th International Conference on Broadband Communications and Biomedical Applications, 2011
Advances in the medical field have introduced new and progressive ways to intensify surgical resi... more Advances in the medical field have introduced new and progressive ways to intensify surgical resident training and surgical skills learning by developing systematic simulator training programs alongside traditional training. Both training methods need constant presence of a competent surgeon to subjectively assess the surgical dexterity of the trainee. Several studies have been conducted to measure user's skill objectively and quantitatively,
Proceedings 2003 International Conference on Image Processing (Cat. No.03CH37429)
Complex human motion sequences (such as dances) are typically analyzed by segmenting !hem into sh... more Complex human motion sequences (such as dances) are typically analyzed by segmenting !hem into shorter motion sequences, called geslures. However, this segmentation process is subjective, and varies considerably from one human observer to another. In this paper, we propose an algorithm called Hierarchical Aclivig Segmentation. This algorithm employs a dynamic hierarchical layered StNcNre to represent the human anatomy, and uses low-level motion parameters to characterize motion in the various layers ofthis hierarchy, which copespond to different segments of thc human body. This characterization is used with a narve Bayesian classifier to derive creator prqfiles from empirical data. Then those profiles are used to predict how creators will segment gestures in other motion sequences. When the predictions were tested with a library of 3D motion capture sequences, which were segmented by 2 choreographers they were found to be reasanably accurate.
This paper proposes design, development and testing of an assistive device for distal environment... more This paper proposes design, development and testing of an assistive device for distal environment perception for individuals who are blind through a haptic user interface (touch-based interface).
18th International Conference on Pattern Recognition (ICPR'06), 2006
Abstract Humans are adept at size classification from visual images of objects. A challenging com... more Abstract Humans are adept at size classification from visual images of objects. A challenging computer vision problem is that of automatic visual size classification. Current size classification systems assume controlled environments and use features geared towards a particular object category and pose. However, certain applications may require algorithms that can adapt to a variety of object categories and handle complex environments. In this paper, we propose a Bayesian approach to automatic visual size classification, inspired ...
Proceedings of the First International Conference on Ambient Media and Systems, 2008
Abstract Over the last few years, Radio-Frequency Identification (RFID) technology has gained pop... more Abstract Over the last few years, Radio-Frequency Identification (RFID) technology has gained popularity for use in assistive technology for individuals who are blind. Recently, RFID-based wearable assistive devices have been developed for individuals who are blind to assist with navigation or remote object perception. However, RFID-based assistive technology suffers from two major drawbacks:(1) information overload in environments with many tagged objects, and (2) usability issues in untagged environments. In this paper, we ...
2008 IEEE International Workshop on Haptic Audio visual Environments and Games, 2008
An issue that complicates movement training, specifically in minimally invasive surgery, is that ... more An issue that complicates movement training, specifically in minimally invasive surgery, is that often there is no one to one correlation between the visual feedback provided on a screen and the movement required to perform the given task. This paper presents a simulator that specifically addresses the intermodal conflict between motor actuation and visual feedback. We developed a virtual reality visio-haptic simulator to assist surgical residents in training to resolve visio-motor conflict. The developed simulator offers individuals the flexibility to train in various scenarios with different levels of visio-motor conflicts. The levels of conflict were simulated by creating a linear functional relation between movement in the real environment and the virtual environment. The haptic rendering was consistent with the visual feedback. Experiments were conducted with expert pediatric surgeons and general surgery residents. Baseline data on performance in conditions of visio-motor conflict were assimilated from expert surgeons. Residents were divided into experimental group that was exposed to visio-motor conflict and the control group which wasn't exposed to visio-motor conflict training. When the performance was compared on a standard surgical suturing task, the residents with intermodal conflict training performed better than the control group suggesting the construct validity of the training and that visio-motor training can accelerate learning.
Proceedings of the 14th annual ACM international conference on Multimedia - MULTIMEDIA '06, 2006
Abstract Surgical movement is composed of discrete gestures that are combined to perform complex ... more Abstract Surgical movement is composed of discrete gestures that are combined to perform complex surgical procedures. A promising approach to objective surgical skill evaluation systems is kinematics and kinetic analysis of hand movement that yields a gesture level analysis of proficiency of a performed movement. In this paper, we propose a novel system that combines surgical gesture segmentation, surgical gesture recognition, and expertise analysis of surgical profiles in minimally invasive surgery (MIS). Kinematic analysis was ...
Surgical residents are exposed to a significant amount of cognitive load during call. While vario... more Surgical residents are exposed to a significant amount of cognitive load during call. While various efforts have been made to quantify the effect of fatigue and sleep deprivation on the psychomotor skills of surgical residents, there is very little investigations into the effect of these factors on cognitive skills. However, this is an important issue in medical curriculum design, as much of the medical errors are procedural in nature and are not psychomotor. In this paper, we present a study that aimed to quantify the effect of fatigue on cognitive skills. We employed hand movement data for developing a proficiency measure of surgical skill. The difference in proficiencies measured through hand movement post call and pre call was determined. The simulation tasks were designed to challenge working memory, attention of the user. The results showed a significant difference in hand movement proficiencies as well as behavioral errors pre and post-call. EEG Data was also gathered during simulation tasks pre and post call through the B-Alert® Bluetooth EEG technology. The B-Alert® software was analyzed to reveal ratings of alertness/drowsiness, engagement, mental workload and distraction. The results showed statistically significant difference in EEG ratings in pre call and post call condition.
BACKGROUND: Fatigue and sleep deprivation and their effects on surgical proficiency have been act... more BACKGROUND: Fatigue and sleep deprivation and their effects on surgical proficiency have been actively researched areas. Past studies that have focused solely on residents have provided an important insight into how fatigue affects residents' ability to perform. This study aims to quantify the effect of fatigue on attending surgeons. METHODS: To quantify the effect of fatigue on psychomotor and cognitive skills of surgical residents and attending surgeons, visiohaptic simulations were created to mimic realistic interactions. RESULTS: Both groups showed a significant decrement in proficiency measures postcall. When tasks were separated based on psychomotor versus cognitive-dominated skills, attending surgeons made 25% fewer (P Ͻ .05) cognitive errors than residents postcall. Psychomotor skills were equally affected in both groups. CONCLUSIONS: Call-associated fatigue is associated with increased error rates in the cognitive skill domain, although less so in attending surgeons compared with their resident counterparts.
BACKGROUND: Surgery training requires residents to focus on tasks while minimizing the effect of ... more BACKGROUND: Surgery training requires residents to focus on tasks while minimizing the effect of distractions. There is a need to develop training methodologies that can enable surgical residents to hone this ability. METHODS: Fourteen surgical residents were divided into 2 groups. They were trained to perform simulated tasks in a noiseless environment and subsequently performed these tasks in a distractive one. In a follow-up experiment, an experimental group was trained in noisy and distractive conditions and was compared with a control group trained in noiseless conditions. RESULTS: Residents who trained in noiseless environments possessed decreased surgical proficiency when performing the identical tasks in realistic environments (P Ͻ .05). Pretraining in a noisy environment improves surgical proficiency. CONCLUSIONS: Noise and distractions can significantly impede performance of surgical residents, but this effect can be nullified by introduction of noise and distractions in the training environment.
BACKGROUND: It is unknown whether surgical residents who learn minimal-access surgery skills in a... more BACKGROUND: It is unknown whether surgical residents who learn minimal-access surgery skills in an unstructured environment (ie, at home), will develop a technical skill set that rivals that of those trained in the more traditional, structured learning environment. METHODS: Seven surgery residents were provided structured learning through didactic and hands-on skills training sessions and consistent supervision throughout training. A second group of 7 residents participated in an unstructured learning curriculum of training without supervision. End points were determined at the end of training using a standardized simulator based on predetermined performance measures. RESULTS: Both groups achieved high task scores, with comparable scores on gesture proficiency, hand movement smoothness, instrument movement smoothness, errors, and time elapsed. There was no significant difference between group differences in final skills scores. CONCLUSIONS: Unstructured learning is equally effective in delivering quality skills training when compared with structured training.
BACKGROUND: Although surgeons perform procedures and tasks under a significant amount of cognitiv... more BACKGROUND: Although surgeons perform procedures and tasks under a significant amount of cognitive load, current simulators focus on training psychomotor skills in isolation. This may limit the transfer of learned skills to actual surgical environments. METHODS: Visuohaptic simulations were created that required participants to hone psychomotor skills in the presence of cognitive load. A control group (n ϭ 7) trained on conventional skills simulator and their performance was compared with the experimental group (n ϭ 7) in terms of learning curves and performance on a transfer task. RESULTS: The experimental group performed significantly better than the control group in terms of both learning curves and performance on the transfer task. CONCLUSIONS: Simulations that combine psychomotor and cognitive skills training are more effective than simulators that focus on psychomotor skills in isolation.
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Papers by Kanav Kahol