Human Factors Research (SURGE)

Training Surgical Skills

To enhance surgical training, new virtual skills trainers are being developed for tasks ranging from fundamentals of laparoscopic surgery to camera navigation and advanced suturing. We have been collaborating on the development and validation of these devices. In particular, in collaboration with Kitware, Inc, we are investigating the use of simulators to support surgeons in the practice of responding to adverse and rare events to improve skill proficiency and resilience.

Surgical Skill Assessment

Systematic and objective evaluation and feedback are crucial for effective training of psychomotor skills involved in point-of-injury care and hospital-based medicine (HBM). Our team has been conducting two large-scale projects, funded by the U.S. Army and in collaboration with RPI and FSU-FAMU, on the use of brain-based and video-based metrics for evaluating skill on laparoscopic suturing and on prolonged field care tasks (endotracheal intubation and cricothyrotomy). Our current studies will be able to show the benefits and limitations of these metrics relative to other measurement modalities for the classification of experts versus novices and how brain activation as individuals train and gain skill on the task. These outcomes will inform training programs, and surgeon and Army medic credentialing standards.

Mental Imagery

Non-invasive functional neuroimaging during surgical tasks has been explored as an objective assessment tool. Our group was the first to monitor brain activity during Fundamentals of Laparoscopic Surgery (FLS) tasks and demonstrated that neuroimaging data can reliably discriminate between novice and expert performance. However, brain activity during cognitive surgical tasks has not yet been examined. Our overall goal is to develop a neuroimaging methodology for the objective evaluation of cognitive surgical tasks.  

Lora Cavuoto, PhD, CPE
Professor, Department of Industrial and Systems Engineering
Research Associate Professor, Department of Surgery

Steven D. Schwaitzberg, MD, FACS
SUNY Distinguished Service Professor and Chairman, Department of Surgery
Professor, Biomedical Informatics

Jing Yang, PhD
Assistant Professor, Department of Industrial and Systems Engineering

Joseph L’Huillier, MD
3^rd Year General Surgery Resident

Abigail Bennett, MD
2^nd Year General Surgery Resident

Gabriel Gazetta, MS
PhD Candidate, Department of Industrial and Systems Engineering

Taylor Quinn
PhD Student, Department of Industrial and Systems Engineering

Manohar Golleru, MS
PhD Student, Department of Industrial and Systems Engineering

1. Surgical Simulator for Improving Skill Proficiency and Resilience (R01), PI: R. Clipp (Kitware, Inc), UB PI: L. Cavuoto, UB Co-Is: W. Chen, S. Schwaitzberg, G. Wilding, 09/2021-05/2025, NIH, UB Subcontract: $487,931
2. Brain-based Metrics for Prolonged Field Care (PFC) Tasks, PI: S. De (RPI), UB PI: L. Cavuoto, UB Co-Is: S. Schwaitzberg, 12/2020-11/2023, Department of Defense, UB Subcontract: $296,795
3. Artificially Intelligent Agents for Investigating Methods for Performance Overdrive (IMPROVE), PI: S. De (RPI), UB PI: L. Cavuoto, UB Co-Is: S. Schwaitzberg, A. Dutta, 10/2020-04/2023, Department of Defense, UB Subcontract: $1,176,649
4. Optimizing the Layout of the Robotic-Assisted Surgery Operating Room, PI: L. Cavuoto, Co-Is: S. Schwaitzberg, D. Yu (Purdue University), 06/2020-09/2022, Intuitive Surgical, $60,000

• Kitware, Inc
• Rensselaer Polytechnic Institute Center for Modeling, Simulation, & Imaging in Medicine
• FSU-FAMU College of Engineering

1. Yanik, E., Schwaitzberg, S., Yang, G., Intes, X., Norfleet, J., Hackett, M., & De, S. (2024). One-shot skill assessment in high-stakes domains with limited data via meta learning. Computers in Biology and Medicine, 174, 108470.
2. Yanik, E., Ainam, J. P., Fu, Y., Schwaitzberg, S., Cavuoto, L., & De, S. (2024). Video-based skill acquisition assessment in laparoscopic surgery using deep learning. Global Surgical Education-Journal of the Association for Surgical Education, 3(1), 26.
3. Walia, P., Fu, Y., Norfleet, J., Schwaitzberg, S. D., Intes, X., De, S., Cavuoto, L., & Dutta, A. (2024). Brain-behavior analysis of transcranial direct current stimulation effects on a complex surgical motor task. Frontiers in Neuroergonomics, 4, 1135729.
4. Obuseh, M., Cavuoto, L., Stefanidis, D., & Yu, D. (2023). A sensor-based framework for layout and workflow assessment in operating rooms. Applied Ergonomics, 112, 104059.
5. Manabe, T., Rahul, F. N. U., Fu, Y., Intes, X., Schwaitzberg, S. D., De, S., Cavuoto, L., & Dutta, A. (2023). Distinguishing Laparoscopic Surgery Experts from Novices Using EEG Topographic Features. Brain Sciences, 13(12), 1706.
6.  Kamat, A., Eastmond, C., Gao, Y., Nemani, A., Yanik, E., Cavuoto, L., Hackett, M., Norfleet, J., Schwaitzberg, S., De, S., & Intes, X. (2023). Assessment of Surgical Tasks Using Neuroimaging Dataset (ASTaUND). Scientific Data, 10(1), 699.
7. Gazetta, G., Miller, C., Clemency, B., Tanaka, K., Hackett, M., Norfleet, J., Rahul, Schwaitzberg, S., De, S., & Cavuoto, L. (2023, September). Evaluating Workload Indicators for Learning During Stress Exposure Training of Endotracheal Intubation. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting (Vol. 67, No. 1, pp. 574-578). Sage CA: Los Angeles, CA: SAGE Publications.
8. Walia, P., Fu, Y., Schwaitzberg, S. D., Intes, X., De, S., Dutta, A., & Cavuoto, L. (2023). Portable neuroimaging differentiates novices from those with experience for the Fundamentals of Laparoscopic Surgery (FLS) suturing with intracorporeal knot tying task. Surgical Endoscopy, 37(7), 5576-5582.
9. Fu, Y., Schwaitzberg, S. D., & Cavuoto, L. (2023). Effects of optical see-through head-mounted display use for simulated laparoscopic surgery. International Journal of Human–Computer Interaction, 1-16.
10. Liu, Y. Z., Shah, S. K., Sanders, C. M., Nwaiwu, C. A., Dechert, A. F., Mehrotra, S., Schwaitzberg, S., Kim, P., & Wilson, E. B. (2023). Utility and usability of laser speckle contrast imaging (LSCI) for displaying real-time tissue perfusion/blood flow in robot-assisted surgery (RAS): comparison to indocyanine green (ICG) and use in laparoscopic surgery. Surgical Endoscopy, 37(6), 4803-4811.
11. Fu, Y., Walia, P., Schwaitzberg, S. D., Intes, X., De, S., Dutta, A., & Cavuoto, L. (2023). Changes in functional neuroimaging measures as novices gain proficiency on the fundamentals of laparoscopic surgery suturing task. Neurophotonics, 10(2), 023521-023521.
12. Lee, S., Shetty, A. S., & Cavuoto, L. A. (2023). Modeling of Learning Processes Using Continuous-Time Markov Chain for Virtual-Reality-Based Surgical Training in Laparoscopic Surgery. IEEE Transactions on Learning Technologies, 17, 462-473.
13. Walia, P., Fu, Y., Norfleet, J., Schwaitzberg, S. D., Intes, X., De, S., Cavuoto, L., & Dutta, A. (2022). Error-related brain state analysis using electroencephalography in conjunction with functional near-infrared spectroscopy during a complex surgical motor task. Brain Informatics, 9(1), 29.
14. Gao, Y., Chao, H., Cavuoto, L., Yan, P., Kruger, U., Norfleet, J. E., Makled, B., Schwaitzberg, S., De., S., & Intes, X. (2022). Deep learning-based motion artifact removal in functional near-infrared spectroscopy. Neurophotonics, 9(4), 041406-041406.
15. Kamat, A., Makled, B., Norfleet, J., Schwaitzberg, S. D., Intes, X., De, S., & Dutta, A. (2022). Directed information flow during laparoscopic surgical skill acquisition dissociated skill level and medical simulation technology. npj Science of Learning, 7(1), 19.
16. Kunkes, T., Makled, B., Norfleet, J., Schwaitzberg, S., & Cavuoto, L. (2022). Understanding the cognitive demands, skills, and assessment approaches for endotracheal intubation: cognitive task analysis. JMIR Perioperative Medicine, 5(1), e34522.
17. Train, A. T., Hu, J., Narvaez, J. R. F., Towle-Miller, L. M., Wilding, G. E., Cavuoto, L., Noyes, K., Hoffman, A., & Schwaitzberg, S. D. (2021). Teaching surgery novices and Trainees advanced Laparoscopic Suturing: a trial and tribulations. Surgical endoscopy, 35, 5816-5826.