Construct validity of computer-assisted assessment: quantification of movement processes during a vascular anastomosis on a live porcine model

Background Movement processes for 2 different suturing techniques within a single surgical task were quantified. Methods Junior (postgraduate years 1–2) and senior residents (postgraduate year 3 and higher) were tested on their ability to perform a vascular anastomosis on a live porcine model 1 week after a guided practice session. Two phases of 2 suturing techniques (parachute and running) were identified, and performance was evaluated during each phase using computer hand motion analysis (CHMA) and expert-based measures. Results Senior residents were more efficient on all segments based on CHMA and expert-based ratings (P < .05). CHMA showed a significant improvement in junior resident performance during each phase of the procedure (warm-up effect). The change in task difficulty during transition from parachute to running sutures was identifiable using CHMA. Conclusions Different suturing techniques are executed using the same general motor program although specific program parameters are adjusted to suit each technique. The findings support a novel form of construct validity the for surgical assessment device, the concept of transfer of skills, and the use of computer evaluations for the assessment of technical skills embedded within complex surgical tasks.