Relating Surgeon Proficiency Scores to Maturation of Visuomotor Skill during Training

Microsurgery remains one of the most technically demanding skills to acquire, as it requires to master fine motor control under high-magnification visual feedback, while acquiring an accurate haptic model of tissue-needle interaction. Surgical training is traditionally assessed by the ALI score, a method easy to administer but that monitors solely the outcome of the surgery. We present a longitudinal evaluation of twenty-two medical students and clinical residents over a six-month period, and compare the evolution of the ALI score errors as a result of practice and training. If visuo-spatial and fine motor skills are only marginally improved over a small period of training and benefit primarily from years of practice, the ability to recognize haptic cues can be acquired after small amount of training. We show that a careful reading of the ALI score errors can be attributed to the acquisition of each of these cognitive processes.