Date of Award

Summer 2018

Document type


Degree Name

MD (Medical Doctor)

First Supervisor

Professor Paul Neary

Second Supervisor

Professor Oscar Traynor

Third Supervisor

Mr Donncha M Ryan


Surgical Education, Surgical Training, Surgical Skills, Skill Assessment, Motion Tracking



Simulation technology is rapidly evolving and becoming the focus of attention in surgical training. However, the development of this technology in assessing open surgical skills is far behind when compared to minimally invasive surgery (MIS) training and assessment.


The overall objective of this thesis is to investigate the assessment tools that are readily available for assessing basic open surgical skills and develop an automated system that could be used in the simulation setting.

Materials & Methods

We evaluated the observer-dependant assessment tool in assessing basic surgical skills including one-handed knot tying and simple interrupted suturing skills. We established a hand tracking system that consists of an off-the-shelf motion analysis device and software created by our co-supervisor which generates numerical metrics. We investigated the validity of these metrics and we examined the potential application of this invaluable assessment tool.


The results demonstrated that the observer-dependant assessment tool has poor inter-rater agreement despite its validity in assessing open surgical skills. The validity of the novel hand tracking system was established. We also demonstrated its application in assessing surgical trainees’ progress and also in proficiency-based assessment.


The hand motion tracking system is a valid assessment tool in evaluating performance in open surgical skills and has a potential significant role in the proficiency-based surgical training programme.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

File Size

3.42 MB


A thesis submitted for the degree of Doctor of Medicine from the Royal College of Surgeons in Ireland in 2018.