To ensure patient safety, educators must train surgeons to set standards of competency, public health officials should put in place policies to ensure surgeons remain competent and surgeons should only perform surgeries that they are competent to perform. Measuring surgeon's technical skill is crucial part of determining if they are competent. Traditionally surgical skill is assessed most commonly during training using subjective non-validated metrics. This leads to variation in the definition of competency. Recent policies set forth by the Accreditation Council of Graduate Medical Education- the governing body for graduate medical education, mandate that technical skill be measured objectively. Currently, there are few valid objective measures available to measure technical competence. Our research will yield a set of tools and methodologies that can be deployed to across medical training programs to objectively measure surgical skill and competence. This platform is also capable of developing new objective measure of skill and competence. Specifically, first, we will develop an objective skills assessment platform, and establish standard data collection and quality assurance protocols for systematic deployment of our platform across multiple institutions. Second, our work will result in automated algorithms and analytic tools to objectivel measure skill using data captured with our platform. Third, we will establish objective methods to determine whether a surgeon is competent to perform surgery. Fourth, we will test the reliability and validity of our assessment tools. We will conduct our study using septoplasty as the prototype test-bed procedure. Septoplasty is a commonly performed procedure (more than 260,000 cases per year) and is a key index surgery by which residents in otolaryngology are evaluated. Our project lays the groundwork for subsequent research to establish national standards for objective skill and competency using data aggregated from numerous training programs in the country.

Public Health Relevance

Policies for graduate medical education require that surgical competency be objectively determined, but currently available technology and methods do not yield objective assessments for surgical skill. Our project aims to provide educators with an integrated objective skills assessment platform and tools for objective determination of competency, which can be readily deployed across graduate surgical training programs in the country.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
5R01DE025265-04
Application #
9526465
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Riddle, Melissa
Project Start
2015-08-01
Project End
2020-07-31
Budget Start
2018-08-01
Budget End
2019-07-31
Support Year
4
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Otolaryngology
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Ahmidi, Narges; Tao, Lingling; Sefati, Shahin et al. (2017) A Dataset and Benchmarks for Segmentation and Recognition of Gestures in Robotic Surgery. IEEE Trans Biomed Eng 64:2025-2041
Vedula, S Swaroop; Ishii, Masaru; Hager, Gregory D (2017) Objective Assessment of Surgical Technical Skill and Competency in the Operating Room. Annu Rev Biomed Eng 19:301-325
Vedula, S Swaroop; Hager, Gregory D (2017) Surgical data science: The new knowledge domain. Innov Surg Sci 2:109-121