Expertise Differences in Fixation, Quiet Eye Duration, and Surgical Performance During Identificatio...
This presentation is the property of its rightful owner.
Sponsored Links
1 / 20

Expertise Differences in Fixation, Quiet Eye Duration, and Surgical Performance During Identification and Dissection of the Recurrent Laryngeal Nerve PowerPoint PPT Presentation


  • 98 Views
  • Uploaded on
  • Presentation posted in: General

Expertise Differences in Fixation, Quiet Eye Duration, and Surgical Performance During Identification and Dissection of the Recurrent Laryngeal Nerve. Harvey, A. 1 Vickers, JN. 2 Snelgrove, R. 1 Scott, M. 2 & Morrison, S. 2 Department of Surgery 1 Faculty of Kinesiology 2

Download Presentation

Expertise Differences in Fixation, Quiet Eye Duration, and Surgical Performance During Identification and Dissection of the Recurrent Laryngeal Nerve

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Expertise differences in fixation quiet eye duration and surgical performance during identification and dissection of the recurrent laryngeal nerve

Expertise Differences in Fixation, Quiet Eye Duration, and Surgical Performance During Identification and Dissection of the Recurrent Laryngeal Nerve

Harvey, A.1 Vickers, JN. 2 Snelgrove, R. 1 Scott, M. 2 & Morrison, S. 2

Department of Surgery 1

Faculty of Kinesiology 2

Association of Surgical Education

Orlando, Florida

April 24, 2013

1

2


Background

Background

  • Halsted Model

    • Apprenticeship Based

    • Graded Responsibility

2


Background1

Background

  • High level athlete gaze, focus of attention, and relation to motor skill has been studied for years

  • Extensive research in sport on the Quiet Eye (QE)

  • Over 70 refereed studies to date in over 15 sports

Quiet eye

location

4


Background2

Background

  • Quiet eye fixation = fixation on a specific location within 1 degree of visual angle (foveal vision) for more than 100 ms prior to successful completion of a critical movement

  • Elite performers have longer duration quiet eye characteristic

  • Quiet eye is also longer during high levels of performance

  • QE training has proven successful in a wide range of sports


Background3

Background

  • Limited literature focus of attention in surgical skills acquirement or training

  • Moulton et al – “Slowing Down” at critical moments


Purpose

Purpose

  • To examine the surgical movements, fixation durations, and Quiet Eye durations of highly experienced (HE) & less experienced (LE) surgeons/residents

7


Hypotheses

Hypotheses

  • HE surgeons will be ranked higher than LE surgeons (blinded external review)

  • HE surgeons will ‘slow down’ using longer Quiet Eye durations on the Recurrent Laryngeal Nerve

8


Methods

Methods

  • Ten Volunteers

    • 3 HE surgeons (M = 2391 operations)

    • 7 LE surgeons (M = 37 operations)

  • Equipment

    • ASL mobile eye tracker

    • Synchronized external video of surgical movements

9


Surgical movements and gaze data

Surgical Movements and Gaze Data

Surgical Movements

Gaze Data


Expertise differences in fixation quiet eye duration and surgical performance during identification and dissection of the recurrent laryngeal nerve

11


Results global rating scores

Results – Global Rating Scores

12


Results global rating score respect for tissue x phase

Results – Global Rating ScoreRespect for Tissue x Phase

Phase 1: Identify Inferior Thyroid Artery

Phase 2: Identify Recurrent Laryngeal Nerve

Phase 3: Divide Ligament of Berry

p < .04

13

13


Results movement time mt

Results – Movement Time (MT%)

p < .98

14


Total fixation duration by phase

Total Fixation Duration by Phase


Quiet eye qe duration on recurrent laryngeal nerve

Quiet Eye (QE) Duration on Recurrent Laryngeal Nerve

p < .008

16

15


Summary

Summary

  • Relative to LE, HE surgeons had:

    • Higher global rating scores

    • No significant differences in operating time, or hand movement times (MT%)

    • Longer fixation durations on the Ligament of Berry

    • Higher QE duration on the RLN prior to blunt and sharp dissections

17


Conclusions

Conclusions

  • HE surgeon’s longer QE duration reveals greater focus of attention on critical structures prior to and during surgical movements

  • HE surgeon’s longer fixations on the LofB suggest the use of a perceptual anchor that is used to define the underlying structures

  • HE surgeonscognitivelyslow down during critical phases of the operation

  • Moulton & Epstein are correct, “slowing down” is a critical cognitive skill of expert surgeons


Future directions

Future Directions

  • Quiet Eye Training

    • Durable

    • Robust under conditions of stress/anxiety

    • Increases success under conditions of exhaustion

  • July 2013 – knot tying for R1 surgical residents


  • Login