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Article: Cutting errors in surgery: Experience limits underestimation bias in a simulated surgical environment

TitleCutting errors in surgery: Experience limits underestimation bias in a simulated surgical environment
Authors
Keywordserror management
laparoscopy
perceptual illusions
surgical errors
surgical estimations
visual feedback
Issue Date2012
Citation
Journal Of Surgical Education, 2012, v. 69 n. 4, p. 473-476 How to Cite?
AbstractOBJECTIVE: Error management is crucial in surgery and needs to be developed through appropriate training and education. Research suggests that perceptual errors may be more likely in laparoscopic environments. The objective of this work is to investigate error management by novices compared with experienced surgeons when performing a simple simulated incision in a visually challenging environment. METHODS: Novices (n = 20) and experienced surgeons (n = 11) viewed pairs of horizontal lines on a laparoscopic monitor. Participants were asked to replicate the line lengths by making simulated incisions. The task was completed with or without online visual feedback of the incising hand. In a second phase of the study, the task was complicated by embedding the lines within a perceptual illusion (i.e., Ponzo illusion). RESULTS: Incision lengths generally were shorter than the actual lengths of the viewed lines for all participants. For the novices, however, this underestimation bias was exacerbated when visual feedback of the incising hand was unavailable (p < 0.001), whereas the surgeons were not affected by loss of vision of the incising hand (p = 0.864). Furthermore, novices were influenced by the perceptual illusion designed to alter perceptions of line length (p = 0.021), whereas the surgeons did not appear to be influenced by the illusion (p = 0.945). CONCLUSIONS: A perceptual bias towards incision length underestimation may be present when surgery involves a laparoscopic monitor; however, surgical experience may protect against accentuation of the underestimation bias when the task becomes more visually challenging. The bias is discussed using the framework of error management theory. © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/149183
ISSN
2015 Impact Factor: 1.95
2015 SCImago Journal Rankings: 0.889
ISI Accession Number ID
Funding AgencyGrant Number
Economic and Social Research Council, UK
Research Grants Council, Hong KongRES-000-22-3016
Funding Information:

The authors acknowledge support for this work by a bilateral research grant from the Economic and Social Research Council, UK and the Research Grants Council, Hong Kong (RES-000-22-3016), awarded to M.R.W. and R.S.W.M.

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorMalhotra, Nen_HK
dc.contributor.authorPoolton, JMen_HK
dc.contributor.authorWilson, MRen_HK
dc.contributor.authorMasters, RSWen_HK
dc.date.accessioned2012-06-22T06:28:13Z-
dc.date.available2012-06-22T06:28:13Z-
dc.date.issued2012en_HK
dc.identifier.citationJournal Of Surgical Education, 2012, v. 69 n. 4, p. 473-476en_HK
dc.identifier.issn1931-7204en_HK
dc.identifier.urihttp://hdl.handle.net/10722/149183-
dc.description.abstractOBJECTIVE: Error management is crucial in surgery and needs to be developed through appropriate training and education. Research suggests that perceptual errors may be more likely in laparoscopic environments. The objective of this work is to investigate error management by novices compared with experienced surgeons when performing a simple simulated incision in a visually challenging environment. METHODS: Novices (n = 20) and experienced surgeons (n = 11) viewed pairs of horizontal lines on a laparoscopic monitor. Participants were asked to replicate the line lengths by making simulated incisions. The task was completed with or without online visual feedback of the incising hand. In a second phase of the study, the task was complicated by embedding the lines within a perceptual illusion (i.e., Ponzo illusion). RESULTS: Incision lengths generally were shorter than the actual lengths of the viewed lines for all participants. For the novices, however, this underestimation bias was exacerbated when visual feedback of the incising hand was unavailable (p < 0.001), whereas the surgeons were not affected by loss of vision of the incising hand (p = 0.864). Furthermore, novices were influenced by the perceptual illusion designed to alter perceptions of line length (p = 0.021), whereas the surgeons did not appear to be influenced by the illusion (p = 0.945). CONCLUSIONS: A perceptual bias towards incision length underestimation may be present when surgery involves a laparoscopic monitor; however, surgical experience may protect against accentuation of the underestimation bias when the task becomes more visually challenging. The bias is discussed using the framework of error management theory. © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.en_HK
dc.languageengen_US
dc.relation.ispartofJournal of Surgical Educationen_HK
dc.subjecterror managementen_HK
dc.subjectlaparoscopyen_HK
dc.subjectperceptual illusionsen_HK
dc.subjectsurgical errorsen_HK
dc.subjectsurgical estimationsen_HK
dc.subjectvisual feedbacken_HK
dc.titleCutting errors in surgery: Experience limits underestimation bias in a simulated surgical environmenten_HK
dc.typeArticleen_HK
dc.identifier.emailPoolton, JM: jamiep@hku.hken_HK
dc.identifier.emailMasters, RSW: mastersr@hku.hken_HK
dc.identifier.authorityPoolton, JM=rp00949en_HK
dc.identifier.authorityMasters, RSW=rp00935en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jsurg.2012.01.002en_HK
dc.identifier.pmid22677584-
dc.identifier.scopuseid_2-s2.0-84861983480en_HK
dc.identifier.hkuros200057en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84861983480&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume69en_HK
dc.identifier.issue4en_HK
dc.identifier.spage473en_HK
dc.identifier.epage476en_HK
dc.identifier.isiWOS:000305366200007-
dc.relation.projectGaze strategies of laparoscopy surgeons: Observational learning, implicit knowledge and performance in demanding conditions-
dc.identifier.scopusauthoridMalhotra, N=36935977200en_HK
dc.identifier.scopusauthoridPoolton, JM=8921750800en_HK
dc.identifier.scopusauthoridWilson, MR=7408663801en_HK
dc.identifier.scopusauthoridMasters, RSW=7102880488en_HK

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