Research

This study, led by Farzad Aghazadeh Shabestari, aims to improve sugical performance in the operating room by developing a new error detection system. The project utilizes his new computer algorithm to compare performance and eye-hand coordination differences between expert and novice surgeons. Six experts and eight novice surgeons were invited to perform a series of laparoscopic tasks, with their eye and motion tracked for analysis. This ongoing project is in collaboration with Dr. Hossein Rouhani and Dr. Mahdi Tavakoli from the Department of Engineering.

The team cognition study is headed by Yao Zhang, who applies her expertise in big data analysis to study human cognition. We are currently trying to discover new ways to measure team cognition, specifically, the shared knowledge among surgical team members working towards common goals. We installed a multi-channel system to record eye and motion-tracking data from a number of surgeons, allowing us to examine the synchronization of their actions, which evolves with experience. The results are crucial in enhancing collaboration and improving team efficiency in the operating room. Yao's skills are used to manage complex data faced when analyzing between-person eye-hand coordination.

What captures an intern's attention when they first step foot into the operating room? By finding the answer to this question, we will have the capabilities of improving surgical education, for instance, creating more suitable OR training videos. To assess this, we developed a virtual operating room (shown in figure) that allow trainees to immerse themselves in the environment and observe a surgical procedure. While they do so, Dr. Lin Wang and Yao Zhang track the eye movements of the participants. This data is then recorded to generate 3-dimensional eye-tracking trajectories. Furthermore, the locations of where visual focus is more frequent, is compared to experienced surgeons, enabling us to visualize differences in visual search strategies. 

Simulation training often involves repetitive practice on models of uniform difficulty, which can limit its effectiveness for skill transfer. To address this, we have developed a workload-adapted protocol that progressively increases in difficulty. Dr. Yun Wu anticipates that this approach will enhance training outcomes and improve bimanual coordination.

In this project, training difficulty was adjusted by varying the size and stability of the target tissue (shown in figure). The silicone target tissues were prepared in three sizes: 1 cm, 0.5 cm, and 0.25 cm wide, with bases offering different levels of stability. The 1-cm silicone pads were mounted on a wooden base for stability, the 0.5-cm pads on a rubber base for moderate mobility, and the 0.25-cm pads on a metal wire base, creating an oscillating, highly unstable platform. These variations introduced three levels of difficulty in the suturing tasks, progressively challenging the student’s motion control.

Preliminary results indicate that the workload-adapted protocol led to improved skill transfer, with performance closely tied to enhanced bimanual coordination.

Yuzhang Li is focused on studying human movement control on dynamic platforms, such as warships, airplanes, and ambulances. To investigate this, we designed a controlled laboratory study where human operators were tasked with performing aiming and pointing exercises under two conditions: one on a stationary platform and the other on a rotating platform (shown in figure).

The difficulty of the tasks was adjusted by varying target distances (D) and target sizes (W), creating three levels of difficulty (ID) according to Fitts' Law. The results showed that movement times were significantly longer on the rotating platform compared to the stationary one, with greater differences observed as task difficulty increased. Furthermore, respiration rates and heart rates were notably higher during tasks performed on the moving platform.

In addition, we identified three behavioral strategies that operators used to compensate for the challenges posed by the moving platform. These findings provide valuable insights into human control mechanisms on dynamic platforms, particularly when both the visual-motor and vestibular systems are interacting.

In medical practice, palpation is an essential skill that enables physicians and surgeons to gather critical information from patient during physical examinations, thus enhancing tactile acuity is crucial. Through palpation, physicians assess an organ’s texture, stiffness, and size using their hands. However, current medical education curricula lack effective training protocols to enhance touch acuity of healthcare trainees.

The main challenges in developing a systematic haptic training curriculum stems from the difficulty in creating reliable training models due to physical limitations. To address this gap, Yuzhang Li employs a haptic feedback device to design a novel training model for tactile acuity within a virtual reality (VR) environment. A series of virtual objects, each with varying physical properties (e.g. ,stiffness, damping, friction, size, shape), are created for trainees to perceive through the haptic device (Touch@, 3D Systems, Rock Hill, South Carolina, USA).

Healthcare trainees will practice palpation skills over nine training sessions, with their touch/tactile acuity evaluated before and after the training. We anticipate that this project will establish a new model for improving skills among healthcare trainees, with significant application across medical schools nationwide. 

This project is led by Dr. Abigail White, who continues her work on the design of a portable and adjustable simulator, aimed at allowing cardiac surgery residents to practice basic surgical skills outside of hospitals. Last year, a total of five UAPACS simulators were produced and distributed to residents. Dr. White collected training data from these users. Using this data, we were able to test the content and construct validity of UAPACS. The simulator demonstrated high functional fidelity to real cardiac surgery and was capable of differentiating between surgeons with varying levels of experience. As the model allows for self-paced practice, residents expressed satisfaction and the majority said they would recommend it to others as an educational tool. The data has been summarized and will be submitted to a surgical journal in the upcoming year.

Over the past year, we have conducted several team-training workshops, enabling cardiac residents to develop advanced skills in managing intraoperative crises in collaboration with other members of the surgical team.