Cannulation is not only one of the most common medical procedures but also fraught with complications. The skill of the clinician performing cannulation directly impacts cannulation outcomes. However, current methods of teaching this skill are deficient, relying on subjective demonstrations and unrealistic manikins that have limited utility for skills training. Furthermore, of the factors that hinders effective continuing medical education is the assumption that clinical experience results in expertise. In this work, we examine if objective metrics acquired from a novel cannulation simulator are able to distinguish between experienced clinicians and established experts, enabling the measurement of true expertise. Twenty-two healthcare professionals, who practiced cannulation with varying experience, performed a simulated arteriovenous fistula cannulation task on the simulator. Four clinicians were peer-identified as experts while the others were designated to the experienced group. The simulator tracked the motion of the needle (via an electromagnetic sensor), rendered blood flashback function (via an infrared light sensor), and recorded pinch forces exerted on the needle (via force sensing elements). Metrics were computed based on motion, force, and other sensor data. Results indicated that, with near 80% of accuracy using both logistic regression and linear discriminant analysis, the objective metrics differentiated between experts and the experienced, including identifying needle motion and finger force as two prominent features that distinguished between the groups. Furthermore, results indicated that expertise was not correlated with years of experience, validating the central hypothesis of the study. These insights contribute to structured and standardized medical skills training by enabling a meaningful definition of expertise and could potentially lead to more effective skills training methods.

插管不仅是最常见的医疗程序之一，而且也充满并发症。临床医生执行插管的技能直接影响插管结果。然而，目前教授该技能的方法存在缺陷，依赖于主观演示和不切实际的人体模型，这些模型对技能训练的效用有限。此外，阻碍有效继续医学教育的因素之一是假设临床经验会产生专业知识。在这项工作中，我们检查了从新型插管模拟器获得的客观指标是否能够区分有经验的临床医生和成熟的专家，从而能够衡量真正的专业知识。22 名医疗保健专业人员，他们从事插管术的经验各不相同，在模拟器上进行了模拟动静脉瘘管插管任务。四名临床医生被指定为专家，而其他人则被指定为经验丰富的小组。模拟器跟踪针的运动（通过电磁传感器），呈现血液闪回功能（通过红外光传感器），并记录施加在针头上的捏力（通过力传感元件）。指标是根据运动、力和其他传感器数据计算的。结果表明，使用逻辑回归和线性判别分析的准确率接近 80%，客观指标区分专家和经验丰富的人，包括识别针运动和手指力作为区分组的两个突出特征。此外，结果表明专业知识与多年经验无关，验证了研究的中心假设。这些见解通过对专业知识进行有意义的定义，有助于结构化和标准化的医疗技能培训，并可能导致更有效的技能培训方法。