Motion Metrics Reliably Differentiate Competency: Fundamentals of Endovascular and Vascular Surgery

Abstract Objective The Fundamentals of Endovascular & Vascular Surgery (FEVS) is a curriculum that includes an endovascular model for skills testing, which aims to differentiate between competent and non-competent performers. The aim of our study is to further validate the model and test its reliability in assessing the performance of endovascular trainees in an uncontrolled setting. Methods The model was tested exclusively in a virtual-reality environment. Fifty-two subjects were divided into three groups based on their endovascular experience: novice ( 500 endovascular cases). Performance was evaluated in four tasks, measuring the tool tip position and velocity on the virtual model. Average tool tip velocity and movement smoothness in the velocity frequency domain are validated parameters defining proficiency of movement. The data were filtered and interpolated to calculate the metrics. Trials containing critical tool manipulation errors were excluded. Results In total 52 tasks completed by novices, 25 completed by intermediates, and 38 completed by experts were analyzed to determine performance. The difference in performance between the novice and expert groups was statistically significant for guidewire smoothness; P Conclusion The FEVS model continues to differentiate novices from experts based on their handling of guidewire and catheter tools, measured as smoothness and velocity. This model offers a useful instrument to test competency in endovascular surgeons.