The Effect of Video Playback Speed on Perception of Technical Skill in Robotic Surgery

Purpose: Previous research has shown that obtaining non-expert crowd evaluations of surgical performances concords with the gold standard of expert surgeon review, and that faster playback speed increases ratings for videos of higher-skilled surgeons in laparoscopic simulation. The aim of this research is to extend this investigation to real surgeries that use non-expert crowd evaluations. We address two questions (1) whether crowds award more favorable ratings to videos shown at increased playback speeds, and (2) if crowd evaluations of the first minute of a surgical procedure differ from crowd evaluations of the entire performance. Methods: A set of 56 videos of practicing surgeons were used to evaluate the technical skill of the surgeons at each video playback speed used for the first minute of the previously rated performance, using the GEARS assessment criteria. Results: Crowds on average did rate videos higher as playback speed was increased. This effect was observed for both proficient and expert surgeons. Each increase in the playback speed by 0.8x was associated with, on average, a 0.16-point increase in the GEARS score for expert surgeons and a 0.27-point increase in GEARS score for proficient surgeons, with both groups being perceived as obtaining relatively equal skill at the fastest playback speed. It was also found that 22 out of the 56 surgeons were perceived to be significantly different in skill when just viewing the first minute of performance. Conclusion: The observed increase in skill ratings with video playback speed replicates findings for laparoscopy in [2], and extends to real robotic surgeries. Furthermore, the large differences in skill labels when comparing the first minute of surgery to the entire 15 minute video warrants further investigation into how much perceived skill ratings vary in time (sub-task level) vs. summative metrics (task level).