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Evaluation of Oculoplastic Surgical Skill

George M. Saleh, MRCSEd, MRCOphth; Vinod Gauba, MRCOphth; Dawn Sim, MRCOphth; Daniel Lindfield, MBBS; Maedeh Borhani, BSc; Salim Ghoussayni, PhD

Arch Ophthalmol. 2008;126(2):213-216.

Objective  To evaluate motion analysis as a discriminator of ophthalmic plastic surgical skill between surgeons of varying experience.

Methods  Thirty subjects were divided into 3 groups based on surgical experience: novice (< 5 performed procedures; n = 10), intermediate (5-100 procedures; n = 10), and expert (> 100 procedures; n = 10). Detailed 3-dimensional motion data from surgeons performing 2 oculoplastic surgical tasks on a wet laboratory skills board were obtained using the Qualisys motion capture system. The first task was a deep 3-1-1 suture. The second was skin closure with a continuous suture. The main outcome measures were time, overall path length, and total number of movements. Kruskal-Wallis analysis was performed to evaluate statistical significance.

Results  Highly significant differences were found during the skin closure task between all groups for mean time (P = .002), overall path length (P = .002), and number of movements (P = .001). For the deep stitch, highly significant differences were also found for time (P < .001), path length (P < .001), and number of movements (P < .001).

Conclusions  Motion analysis, using this technology, was able to differentiate between surgeons of varying experience performing oculoplastic tasks, thus demonstrating construct validity. This technique may be useful in the objective quantitative measurement of oculoplastic skill, with potential applications for training and research.

Author Affiliations: Frimley Park Hospital (Drs Saleh, Sim, and Lindfield) and Department of Biomedical Engineering, University of Surrey (Dr Ghoussayni and Ms Borhani), Surrey, Moorfields Eye Hospital, London (Drs Saleh and Sim), and St James Hospital, Leeds (Dr Gauba), England.

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