Plastic Surgery Research Council
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USING MOTION ANALYSIS TO PROVIDE IMMEDIATE FEEDBACK IN MICROSURGERY EDUCATION
Presenter: Ji Son, MS
Co-Authors: Satterwhite T; Lee GK
Stanford

Motion analysis has been utilized in sports to provide feedback for acquisition skills by delineating metrics to attain proficiency. Microsurgery requires not only knowledge, but strong technical skills that can only be attained with practice. Practicing is paramount but without observation of senior attending surgeons, there is no opportunity for residents to obtain feedback. At our institution, we created a platform for expert surgeons to provide feedback to residents, which proved to be a time intensive process. Therefore, we sought a method to provide constructive, immediate feedback. Although there has been motion analysis of laparoscopic procedures in the literature, none has outlined a method to provide useful feedback to residents. We used three models (practice card, PTFE graft, and chicken foot) for sixteen plastic surgery trainees (PGY1-6) to practice microsurgery. The sessions were recorded, which were evaluated by senior surgeons using a previously validated global ratings scale. Subsequently, residents motions were analyzed using a motion analysis software for hand angles, number of movements, velocity and acceleration of movements in specific tasks such as cutting and knot tying. The results were compared to that of an expert microsurgeon who participated in the same exercises to define ideal movement sequences. Participant performance was analyzed for each PGY and stratified according to tasks. Junior residents had increased number, velocity, and acceleration of movements in every task. Additionally, movements of junior residents had more deviation from movements of expert surgeons compared to senior residents. Data and feedback was provided to the residents outlining suggestions to facilitate performance improvement and skills acquisition. As expected, senior trainees performed on average better than junior trainees. Motion analysis provides identification of superior, reproducible metrics that allow assessment and comparison of experts versus residents. By providing immediate feedback, the residents are able to gain insights into the structure and acquisition of microsurgery to improve.


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