Can Video Based Assessment Predict Surgeon Experience in Robotic Bariatric Surgery?
EAES Academy. Addison P. 07/05/22; 363107; P152
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Abstract
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Introduction:
Video-based assessment (VBA) is being increasingly used to develop objective methods of evaluating surgical skill. The Global Evaluative Assessment of Robotic Skills (GEARS) rubric uses a validated Likert scale to score technical skill in robotic surgery and is conducive for scoring via VBA. If more experienced surgeons are more technically skilled and if the GEARS scores accurately assess technical skill, we hypothesize that more experienced surgeons should have higher GEARS scores.
Methods:
Patients undergoing elective robotic sleeve gastrectomy at a multicenter healthcare institution from June 2016 to March 2020 were retrospectively analyzed from a prospectively collected database. For step-specific scoring, videos were broken down into three steps: greater curve dissection, gastric transection, and oversewing the staple line. Overall and step-specific GEARS scores were assigned by crowd-sourced evaluators. Surgeons were divided into 3 groups according to time in practice: less than 5 years (group 1); between 5 and 15 years (group 2); and more than 15 years (group 3). Univariate and multivariate analysis were performed to identify the relationship between intraoperative variables and surgeon experience.
Results:
Fourteen surgeons performing 153 cases were included for review. The majority of surgeons had fewer than 5 years of practice (n = 6, 42.4% vs group 2: n = 5, 35.7 and group 3: n = 3, 21.5%). More experienced surgeons had higher mean GEARS scores (19.68 ± 0.88, 20.18 ± 0.80 and 20.21 ± 0.65 for groups 1, 2 and 3 respectively, p < 0.001) and tended to have shorter operative times (77±41 minutes, 62±27 minutes and 50±25 minutes for groups 1, 2 and 3 respectively, p < 0.001). GEARS subcomponent scores for depth perception (p < 0.001), robotic
control (p = 0.003) and force sensitivity (p = 0.003) correlated with increasing surgical experience. On multivariable logistic regression, operative time (p = 0.027) and depth perception (p = 0.033) were independently associated with surgical experience.
Conclusions:
In our VBA model, operative time and the GEARS subcomponent depth perception were independently associated with surgical experience. Further studies are needed to determine the association between intraoperative variables gathered by VBA and surgical outcomes.
Figure 1. Overall GEARS Score vs Surgeon Experience
GEARS = global evaluative assessment of robotic skills, CI = confidence interval
Video-based assessment (VBA) is being increasingly used to develop objective methods of evaluating surgical skill. The Global Evaluative Assessment of Robotic Skills (GEARS) rubric uses a validated Likert scale to score technical skill in robotic surgery and is conducive for scoring via VBA. If more experienced surgeons are more technically skilled and if the GEARS scores accurately assess technical skill, we hypothesize that more experienced surgeons should have higher GEARS scores.
Methods:
Patients undergoing elective robotic sleeve gastrectomy at a multicenter healthcare institution from June 2016 to March 2020 were retrospectively analyzed from a prospectively collected database. For step-specific scoring, videos were broken down into three steps: greater curve dissection, gastric transection, and oversewing the staple line. Overall and step-specific GEARS scores were assigned by crowd-sourced evaluators. Surgeons were divided into 3 groups according to time in practice: less than 5 years (group 1); between 5 and 15 years (group 2); and more than 15 years (group 3). Univariate and multivariate analysis were performed to identify the relationship between intraoperative variables and surgeon experience.
Results:
Fourteen surgeons performing 153 cases were included for review. The majority of surgeons had fewer than 5 years of practice (n = 6, 42.4% vs group 2: n = 5, 35.7 and group 3: n = 3, 21.5%). More experienced surgeons had higher mean GEARS scores (19.68 ± 0.88, 20.18 ± 0.80 and 20.21 ± 0.65 for groups 1, 2 and 3 respectively, p < 0.001) and tended to have shorter operative times (77±41 minutes, 62±27 minutes and 50±25 minutes for groups 1, 2 and 3 respectively, p < 0.001). GEARS subcomponent scores for depth perception (p < 0.001), robotic
control (p = 0.003) and force sensitivity (p = 0.003) correlated with increasing surgical experience. On multivariable logistic regression, operative time (p = 0.027) and depth perception (p = 0.033) were independently associated with surgical experience.
Conclusions:
In our VBA model, operative time and the GEARS subcomponent depth perception were independently associated with surgical experience. Further studies are needed to determine the association between intraoperative variables gathered by VBA and surgical outcomes.
Figure 1. Overall GEARS Score vs Surgeon Experience
GEARS = global evaluative assessment of robotic skills, CI = confidence interval
Introduction:
Video-based assessment (VBA) is being increasingly used to develop objective methods of evaluating surgical skill. The Global Evaluative Assessment of Robotic Skills (GEARS) rubric uses a validated Likert scale to score technical skill in robotic surgery and is conducive for scoring via VBA. If more experienced surgeons are more technically skilled and if the GEARS scores accurately assess technical skill, we hypothesize that more experienced surgeons should have higher GEARS scores.
Methods:
Patients undergoing elective robotic sleeve gastrectomy at a multicenter healthcare institution from June 2016 to March 2020 were retrospectively analyzed from a prospectively collected database. For step-specific scoring, videos were broken down into three steps: greater curve dissection, gastric transection, and oversewing the staple line. Overall and step-specific GEARS scores were assigned by crowd-sourced evaluators. Surgeons were divided into 3 groups according to time in practice: less than 5 years (group 1); between 5 and 15 years (group 2); and more than 15 years (group 3). Univariate and multivariate analysis were performed to identify the relationship between intraoperative variables and surgeon experience.
Results:
Fourteen surgeons performing 153 cases were included for review. The majority of surgeons had fewer than 5 years of practice (n = 6, 42.4% vs group 2: n = 5, 35.7 and group 3: n = 3, 21.5%). More experienced surgeons had higher mean GEARS scores (19.68 ± 0.88, 20.18 ± 0.80 and 20.21 ± 0.65 for groups 1, 2 and 3 respectively, p < 0.001) and tended to have shorter operative times (77±41 minutes, 62±27 minutes and 50±25 minutes for groups 1, 2 and 3 respectively, p < 0.001). GEARS subcomponent scores for depth perception (p < 0.001), robotic
control (p = 0.003) and force sensitivity (p = 0.003) correlated with increasing surgical experience. On multivariable logistic regression, operative time (p = 0.027) and depth perception (p = 0.033) were independently associated with surgical experience.
Conclusions:
In our VBA model, operative time and the GEARS subcomponent depth perception were independently associated with surgical experience. Further studies are needed to determine the association between intraoperative variables gathered by VBA and surgical outcomes.
Figure 1. Overall GEARS Score vs Surgeon Experience
GEARS = global evaluative assessment of robotic skills, CI = confidence interval
Video-based assessment (VBA) is being increasingly used to develop objective methods of evaluating surgical skill. The Global Evaluative Assessment of Robotic Skills (GEARS) rubric uses a validated Likert scale to score technical skill in robotic surgery and is conducive for scoring via VBA. If more experienced surgeons are more technically skilled and if the GEARS scores accurately assess technical skill, we hypothesize that more experienced surgeons should have higher GEARS scores.
Methods:
Patients undergoing elective robotic sleeve gastrectomy at a multicenter healthcare institution from June 2016 to March 2020 were retrospectively analyzed from a prospectively collected database. For step-specific scoring, videos were broken down into three steps: greater curve dissection, gastric transection, and oversewing the staple line. Overall and step-specific GEARS scores were assigned by crowd-sourced evaluators. Surgeons were divided into 3 groups according to time in practice: less than 5 years (group 1); between 5 and 15 years (group 2); and more than 15 years (group 3). Univariate and multivariate analysis were performed to identify the relationship between intraoperative variables and surgeon experience.
Results:
Fourteen surgeons performing 153 cases were included for review. The majority of surgeons had fewer than 5 years of practice (n = 6, 42.4% vs group 2: n = 5, 35.7 and group 3: n = 3, 21.5%). More experienced surgeons had higher mean GEARS scores (19.68 ± 0.88, 20.18 ± 0.80 and 20.21 ± 0.65 for groups 1, 2 and 3 respectively, p < 0.001) and tended to have shorter operative times (77±41 minutes, 62±27 minutes and 50±25 minutes for groups 1, 2 and 3 respectively, p < 0.001). GEARS subcomponent scores for depth perception (p < 0.001), robotic
control (p = 0.003) and force sensitivity (p = 0.003) correlated with increasing surgical experience. On multivariable logistic regression, operative time (p = 0.027) and depth perception (p = 0.033) were independently associated with surgical experience.
Conclusions:
In our VBA model, operative time and the GEARS subcomponent depth perception were independently associated with surgical experience. Further studies are needed to determine the association between intraoperative variables gathered by VBA and surgical outcomes.
Figure 1. Overall GEARS Score vs Surgeon Experience
GEARS = global evaluative assessment of robotic skills, CI = confidence interval
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