Standardization of surgical procedures for identifying best practices and training.

T. Armstrong, D. Yu, A. Frischknecht, R. Minter, P. Andreatta, S. Kasten

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

A taxonomy was developed a) to describe surgical procedures with sufficient detail to review differences among surgeons, b) to examine the relationship between individual technique and outcomes, c) to enable surgeons to standardize technique around best practices and d) to identify clinical-evidence-based key points of teaching and assessment for surgical training. Sixty-seven microvascular anastomoses were recorded through video cameras mounted in the dissecting microscope. A hierarchical task analysis was used to decompose the observed procedures into successive levels of detail. The results were then presented to individual and small groups of microvascular surgeons to help define steps and step attributes necessary to describe a procedure so that other surgeons can perform the procedure exactly the same way. Coincidently, it was found that because the surgeons' attention is confined to a very small field of view in which they can see only the veins and arteries and the ends of their instruments, they often have difficulty communicating with others in the operating room. Analyses of selected cases using the proposed taxonomy shows how subtle details are revealed that may affect outcomes, and indicate specific training needs. By comparing different methods and outcomes, it should be possible to identify best practices for given conditions.

Original languageEnglish (US)
Pages (from-to)4673-4679
Number of pages7
JournalWork
Volume41
Issue numberSUPPL.1
DOIs
Publication statusPublished - Apr 23 2012

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Keywords

  • methods
  • standardization
  • Surgery
  • task analysis
  • taxonomy
  • training

ASJC Scopus subject areas

  • Rehabilitation
  • Public Health, Environmental and Occupational Health

Cite this

Armstrong, T., Yu, D., Frischknecht, A., Minter, R., Andreatta, P., & Kasten, S. (2012). Standardization of surgical procedures for identifying best practices and training. Work, 41(SUPPL.1), 4673-4679. https://doi.org/10.3233/WOR-2012-0108-4673