Idle time: an underdeveloped performance metric for assessing surgical skill

BACKGROUND: The aim of this study was to evaluate validity evidence using idle time as a performance measure in open surgical skills assessment. METHODS: This pilot study tested psychomotor planning skills of surgical attendings (n = 6), residents (n = 4) and medical students (n = 5) during suturing tasks of varying difficulty. Performance data were collected with a motion tracking system. Participants' hand movements were analyzed for idle time, total operative time, and path length. We hypothesized that there will be shorter idle times for more experienced individuals and on the easier tasks. RESULTS: A total of 365 idle periods were identified across all participants. Attendings had fewer idle periods during 3 specific procedure steps (P < .001). All participants had longer idle time on friable tissue (P < .005). CONCLUSIONS: Using an experimental model, idle time was found to correlate with experience and motor planning when operating on increasingly difficult tissue types. Further work exploring idle time as a valid psychomotor measure is warranted. (C) 2015 Elsevier Inc. All rights reserved.