Video-analysis for the assessment of practical skill

Abstract

Objective: To review the literature on the application of video review and analytics on surgical education and quality improvement. Background: Analysis of past performance is a mandatory component in many industries, yet the idea is in its infancy in surgical assessment. Evaluation of surgical skill, both technical and non-technical, is possible through video analysis methods. Adverse outcomes in surgery are related in part to errors committed by the surgical team, and review of intraoperative footage allows for detailed analysis and improvement of skills and systems that contribute to patient safety. Methods: In this article we review the literature pertaining to post hoc assessment of surgical performance, including technical skill and error, and non-technical skill and surgical coaching. We describe our group’s novel ‘OR blackbox’ method of detailed video analysis, and how we synthesize multiple metrics of performance collected through audiovisual pathways into compartmentalized, usable data. Results: Qualitative and Quantitative video analysis has been applied to multiple fields of surgery. Tools for assessment of metrics across the spectrum of intraoperative factors exist and their validity and reliability is supported in the literature. Emerging evidence supports the use of retrospective evaluation of surgical technique in ensuring optimal outcomes for patients. Educators are using video analysis to identify aspects of surgical procedures to target for deliberate practice, and the role of coaching in surgery is greatly enhanced with review of cases. Conclusion: Identification of crucial events related to safety and surgical skill are not always identifiable in real time. Video analysis allows surgeons and educators to assess intraoperative factors that influence the patient’s surgical outcomes and safety. Assessment of technical skill, non-technical skill, and surgical error are possible through comprehensive video recording and analysis techniques.