Timothy M. Kowalewski

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BACKGROUND Laparoscopic psychomotor skills are challenging to learn and objectively evaluate. The Fundamentals of Laparoscopic Skills (FLS) program provides a popular, inexpensive, widely-studied, and reported method for evaluating basic laparoscopic skills. With an emphasis on training safety before efficiency, we present data that explore the metrics in(More)
BACKGROUND Preoperative simulation warm-up has been shown to improve performance and reduce errors in novice and experienced surgeons, yet existing studies have only investigated conventional laparoscopy. We hypothesized that a brief virtual reality (VR) robotic warm-up would enhance robotic task performance and reduce errors. STUDY DESIGN In a 2-center(More)
BACKGROUND Validated methods of objective assessments of surgical skills are resource intensive. We sought to test a web-based grading tool using crowdsourcing called Crowd-Sourced Assessment of Technical Skill. MATERIALS AND METHODS Institutional Review Board approval was granted to test the accuracy of Amazon.com's Mechanical Turk and Facebook(More)
PURPOSE Rapid adoption of robot-assisted surgery has outpaced our ability to train novice roboticists. Objective metrics are required to adequately assess robotic surgical skills and yet surrogates for proficiency, such as economy of motion and tool path metrics, are not readily accessible directly from the da Vinci® robot system. The trakSTAR™ Tool Tip(More)
PURPOSE We examined the face, content and construct validity of version 1.0 of the University of Washington transurethral prostate resection (TURP) trainer. MATERIALS AND METHODS Version 1.0 of a virtual reality based simulator for transurethral skills was developed at our laboratory by integrating TURP hardware with our virtual 3-dimensional anatomy,(More)
BACKGROUND Crowdsourcing is the practice of obtaining services from a large group of people, typically an online community. Validated methods of evaluating surgical video are time-intensive, expensive, and involve participation of multiple expert surgeons. We sought to obtain valid performance scores of urologic trainees and faculty on a dry-laboratory(More)
PURPOSE To understand how urologists acquire resection skills we analyzed factors correlating with favorable resection metrics in groups defined as experts, residents and novices. We then evaluated discriminate validity by determining factors correlating with proficiency among individuals in the expert, resident and novice groups. MATERIALS AND METHODS A(More)
BACKGROUND A surgeon's skill in the operating room has been shown to correlate with a patient's clinical outcome. The prompt accurate assessment of surgical skill remains a challenge, in part, because expert faculty reviewers are often unavailable. By harnessing the power of large readily available crowds through the Internet, rapid, accurate, and low-cost(More)
BACKGROUND Objective quantification of surgical skill is imperative as we enter a healthcare environment of quality improvement and performance-based reimbursement. The gold standard tools are infrequently used due to time-intensiveness, cost inefficiency, and lack of standard practices. We hypothesized that valid performance scores of surgical skill can be(More)
Surgical robotic systems and virtual reality simulators have introduced an unprecedented precision of measurement for both tool-tissue and tool-surgeon interaction; thus holding promise for more objective analyses of surgical skill. Integrative or averaged metrics such as path length, time-to-task, success/failure percentages, etc., have often been employed(More)