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Assessing Technical Skill in Surgery and Endoscopy: A Set of Metrics and an Algorithm (C-PASS) to Assess Skills in Surgical and Endoscopic Procedures

Department of Surgery, Massachusetts General Hospital, Harvard Medical School, CIMIT Image Guidance Laboratory, Massachusetts General Hospital, Boston, Massachusetts

Kirby G. Vosburgh, PhD

Center for Integration of Medicine and Innovative Technology and the Brigham and Women's Hospital, Harvard Medical School, kirby{at}bwh.harvard.edu, CIMIT Image Guidance Laboratory, Massachusetts General Hospital, Boston, Massachusetts

Historically, the performance of surgeons has been assessed subjectively by senior surgical staff in both training and operating environments. In this work, the position and motion of surgical instruments are analyzed through an objective process, denoted C-PASS, to measure surgeon performance of laparoscopic, endoscopic, and image-guided procedures. To develop C-PASS, clinically relevant performance characteristics were identified. Then measurement techniques for parameters that represented each characteristic were derived, and analytic techniques were implemented to transform these parameters into explicit, robust metrics. The metrics comprise the C-PASS performance assessment method, which has been validated over the last 3 years in studies of laparoscopy and endoscopy. These studies show that C-PASS is straightforward, reproducible, and accurate. It is sufficiently powerful to assess the efficiency of these complex processes. It is likely that C-PASS and similar approaches will improve skills acquisition and learning and also enable the objective comparison of systems and techniques.

Key Words: surgical performance • laparoscopy • endoscopy • performance characterization

Surgical Innovation, Vol. 14, No. 2, 113-121 (2007)
DOI: 10.1177/1553350607302330


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