The computerized objective assessment of surgical skills: Considerations
for counting the number of movements
Abstract
Motion capture and analysis techniques are emerging in the surgical
education and surgical education research literature as viable ways to
augment the assessment of technical skills. In particular, these methods
provide an opportunity to reveal objective information about the
efficiency of surgical procedures, above and beyond the accuracy of
procedural outcomes. One assessment that is very prevalent in the
literature are counts of the number of movements a surgeon makes in
completing a technical performance. In this commentary, the number of
movements metric is explored from kinesiology and engineering
perspectives; two disciplines that have contributed heavily to the
development of rigorous motion analysis methods. Furthermore, the
assumption that skill efficiency improves linearly as a learner
progresses along the continuum of expertise is challenged. While
movement efficiency does certainly improve, this assumption does not
necessarily capture the way that learners flexibly prioritize particular
aspects of performance in the intermediate stages of skill learning. By
way of this commentary, important a priori decisions that should proceed
effective motion capture and analysis are highlighted, a call for the
standardization of procedures is made, and an opportunity to better
understand the way that computerized movement analysis techniques may
contribute (or be detrimental) to competency constructs in surgical
education and assessment is realized.