Abstract
ABSTRACT
Background
Surgical assessment often relies on subjective expert observation, which may introduce bias. We aimed to objectively differentiate skill levels in a complex simulated operative procedure using hand‐tracking metrics through a wearable mixed reality headset.
Methods
A validated paediatric open inguinal herniotomy simulator was used to simulate a surgical task composed of multiple sequential operative steps. Novices (medical students) and experts (paediatric surgeons) were recruited. After completing a pre‐task questionnaire, participants performed the task while wearing the mixed reality headset (Microsoft HoloLens 2). A post‐task questionnaire was completed. Metrics collected included total path length, average path length, average movement velocity and total time. Data are reported as mean (± SD) and analysis included descriptive statistics, frequency counts and comparative testing using
t
‐tests. A
p
‐value of
Results
A total of 33 participants were recruited (9 experts, 24 novices). The expert group had a shorter mean total path length: 287.0 ± 60.0 cm versus 450.1 ± 55.7 cm (
p
p
p
= 0.13). Experts took less time to complete the task: 458.1 ± 65.8 s versus 836.0 ± 70.0 s (
p
Conclusions
This study objectively demonstrated that experts had a more efficient economy of movement and that hand‐tracking metrics can differentiate between novice and expert performance during a simulated complex surgical task.