Best Medical Education Abstract Awardee 2014: Using motion analysis to assess experience in flexible bronchoscopy

Dr. Sara Colella, MD 1, Mr. Morten Svendsen, M.Sc.Eng 2., Dr. Lars Konge, MD 2, Prof. Lars Bo Svendsen, MD 3 and Dr. Paul Clementsen, MD 1. 1 Department of Pulmonology, Copenhagen University Hospital Gentofte, Hellerup, Denmark, 2900 2 Center for Clinical Education, The Capital Region of Denmark, Copenhagen, Denmark, 2100 3 Department of Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark, 2100. Body: Background Flexible bronchoscopy should be performed with a correct posture and a straight scope to optimize scope movement and minimize the risk of work-related injuries and damage to the scope. Aims and objectives The aims of the study were to test whether an automatic motion analysis system could be used to track the appearance of the scope, and to explore if scope appearance correlated with operator experience. Our hypothesis was that more experienced bronchoscopists would keep the flexible scope straighter while performing procedures. Methods Eleven novices, nine intermediates, and nine experts in bronchoscopy performed three procedures each on a bronchoscopy simulator. The Microsoft Kinect system was used to automatically measure the total deviation of the scope from a perfectly straight, vertical line. Results The low-cost motion analysis system could precisely measure the accumulated deviation of the scope during the procedure. The deviations were largest for the novices and smallest for the experts for all three procedures, p=0.01, p=0.02, and p=0.04 respectively Conclusions Novices and intermediates bend the flexible bronchoscope more than experts. We propose to use an automatic motion analysis feedback system to teach new bronchoscopists how to handle the bronchoscope like an expert - "Keep the scope straight"