Surgeons as Educators A Guide for Academic Development and Teaching Excellence

84

strategist and chess player, was beaten at the game by an 1800s version of a robot,
painted and dressed to look Turkish. The defeat was of course not from artificial
intelligence but from man, one who would puppeteer the device while hidden inside).
Mechanical Turks complete Human Intelligence Tasks (HITs) for pay; some are
very simple and only earn a few pennies, and others require specific skill and can
earn several dollars. HITS are approved by the agency requesting the task, and each
workers approval rating can be viewed before they are hired for a task.
Crowd-sourcing videos of surgeons performing dry lab or operative procedures
is becoming an increasingly popular means of evaluating training regimes. The first

Table 5.3 GEARS

Depth

perception

1

Constantly

overshoots target,

wide swings, slow

to correct

2 3

Some overshooting

or missing of target

but quick to correct

4 5

Accurately directs

instruments in the

correct plane to the

target

Bimanual

dexterity

1

Uses only one

hand, ignores

nondominant hand,

poor coordination

2 3

Uses both hands but

does not optimize

interaction between

hands

4 5

Expertly uses both

hands in a

complementary way to

provide best exposure

Efficiency 1

Inefficient efforts;

many uncertain

movement

constantly

changing focus or

persisting without

progress

2 3

Slow but planned

movements are

reasonably organized

4 5

Confident, efficient, and

safe conduct; maintains

focus on task, fluid

progression

Force

Sensitivity

1

Rough moves, tears

tissue, injuries

nearby structures,

poor control

frequent suture

breakage

2 3

Handles tissues

reasonably well,

minor trauma to

adjacent tissue, rare

suture breakage

4 5

Applies appropriate

tension, negligible

injury to adjacent

structures, no suture

breakage

Autonomy 1

Unable to complete

entire task, even

with verbal

guidance

2 3

Able to complete

task safely with

moderate guidance

4 5

Able to complete task

independently without

prompting

Robotic

Control

1

Consistently does

not optimize view,

hand position, or

repeated collisions

even with guidance

2 3

View is sometimes

not optimal.

Occasionally needs

to relocate arms;

occasional collisions

and obstruction of

assistant

4 5

Controls camera and

hand position optimally

and independently.

Minimal collisions or

obstruction of assistant

Adapted from Goh et al [ 44 ].

E.I. George et al.