Date of Award
12-2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Industrial Engineering
Committee Chair/Advisor
Jackie Cha
Committee Member
Alfredo Carbonell
Committee Member
Rose Figueroa
Committee Member
Divya Srinivasan
Abstract
This dissertation presents a series of studies targeted at improving surgical decision-making training for minimally invasive surgical (MIS) skills. While training tools exist to develop technical skills of trainees, these often overlook the decision-making process that coincides with executing these skills properly. Proper surgical decision-making skills are typically transferred to trainees informally from expert surgeons. However, trainees often practice independently during early stages of training and may not receive the necessary feedback to develop their decision-making skills. The goal of this dissertation was to better understand expert and novice decision-making to inform the development of guided, virtual, decision-making training tools to support trainees during independent practice. First, a scoping review was completed to understand the current applications of extended reality (XR) as a tool to train decision-making as part of a broader search of nontechnical skills. Then, a mixed-methods study was completed to identify how trainees and expert surgeons approach MIS training tasks and how their decision-making models differed. Qualitative and quantitative data were obtained to develop unique mental model frameworks of trainees and experts, the common challenges trainees faced, and how experts overcome them were identified. This information was used to inform the development of an XR-based feedback system to support trainee decision-making during independent training, and it was found that novices found XR-based feedback as an engaging method of learning. These findings contribute to the human factors and surgical field by demonstrating how decision-making can be captured and incorporated into training curricula to improve surgical training and outcomes.
Recommended Citation
Gonzales, Alec J., "Decision-Making Training of Minimally Invasive Surgical Skills" (2025). All Dissertations. 4176.
https://open.clemson.edu/all_dissertations/4176
Author ORCID Identifier
0000-0002-6747-1179