Analysis of Kinematic Differences in Hand Motion between Novice and Experienced Operators in IR: A Pilot Study

Purpose: To prospectively validate electromagnetic hand motion tracking in interventional radiology to detect differences in operator experience using simulation. Methods: Sheath task: Six attending interventional radiologists (experts) and 6 radiology trainees (trainees) placed a wire through a sheath and performed a "pin-pull" maneuver, while an electromagnetic motion detection system recorded the hand motion. Radial task: Eight experts and 12 trainees performed palpatory radial artery access task on a radial access simulator. The trainees repeated the task with the nondominant hand. The experts were classified by their most frequent radial artery access technique as having either palpatory, ultrasound, or overall limited experience. The time, path length, and number of movements were calculated. Mann-Whitney U tests were used to compare the groups, and P <.05 was considered significant. Results: Sheath task: The experts took less time, had shorter path lengths, and used fewer movements than the trainees (11.7 seconds +/- 3.3 vs 19.7 seconds +/- 6.5, P <.01; 1.1 m +/- 0.3 vs 1.4 m +/- 0.4, P <.01; and 19.5 movements +/- 8.5 vs 31.0 movements +/- 8.0, P <.01, respectively). Radial task: The experts took less time, had shorter path lengths, and used fewer movements than the trainees (24.2 seconds +/- 10.6 vs 33.1 seconds +/- 16.9, P <.01; 2.0 m +/- 0.5 vs 3.0 m +/- 1.9, P <.001; and 36.5 movements +/- 15.0 vs 54.5 movements +/- 28.0, P <.001, respectively). The trainees had a shorter path length for their dominant hand than their nondominant hand (3.0 m +/- 1.9 vs 3.5 m +/- 1.9, P <.05). The expert palpatory group had a shorter path length than the ultrasound and limited experience groups (1.8 m +/- 0.4 vs 2.0 m +/- 0.4 and 2.3 m +/- 1.2, respectively, P <.05). Conclusions: Electromagnetic hand motion tracking can differentiate between the expert and trainee operators for simulated interventional tasks.