Medical Student UT Health San Antonio San Antonio, Texas
Background: Handheld instruments operated by a foot-pedal such as microdebriders are commonly used in rhinologic surgeries. Critical structures can be injured by such tools; thus, quick and accurate reaction times (RTs) are needed to avoid injury. The objective of this study was to determine RTs in the hands and feet, as well as hand accuracy in different body positions.
Methods: A tablet-based simulation was created to test 1) foot pedal RTs and 2) hand dexterity. The tablet randomly displayed green and red dots. Subjects were to touch the green dots with their finger while depressing the pedal. The pedal was released upon display of red dots, meant to signify approach of critical structures (and stopping the microdebrider). Subjects were tested under 4 conditions recording foot pedal RTs, accuracy, and the speed of touching dots.
Results: 8 faculty, 10 residents, and 31 students completed the simulation. The mean RTs for pedal release in the sitting position (548.69 ms ± 66.17) were significantly shorter than the mean RTs for pedal release in the standing position (613.29 ms ± 96.53) (p < 0.001). Faculty had the best mean hand accuracy (15.57 pixels ± 2.15 away from center) while first year medical students had the lowest accuracy (21.11 pixels ± 0.19 away from center) (p=0.016).
Conclusions: Rhinologists must have the proficiency to use pedal-operated surgical tools and the dexterity to cease use when structures are at risk. These results suggest position affects the ability to optimize both tasks. The faster pedal RT in seated position and training may reduce the risk of trauma during rhinologic surgery when pedal-operated tools are used.