Bio


Carla Pugh is Professor of Surgery at Stanford University School of Medicine. She is also the Director of the Technology Enabled Clinical Improvement (T.E.C.I.) Center. Her clinical area of expertise is Acute Care Surgery. Dr. Pugh obtained her undergraduate degree at U.C. Berkeley in Neurobiology and her medical degree at Howard University School of Medicine. Upon completion of her surgical training at Howard University Hospital, she went to Stanford University and obtained a PhD in Education. She is the first surgeon in the United States to obtain a PhD in Education. Her goal is to use technology to change the face of medical and surgical education.

Her research involves the use of simulation and advanced engineering technologies to develop new approaches for assessing and defining competency in clinical procedural skills. Dr. Pugh holds three patents on the use of sensor and data acquisition technology to measure and characterize hands-on clinical skills. Currently, over two hundred medical and nursing schools are using one of her sensor enabled training tools for their students and trainees. Her work has received numerous awards from medical and engineering organizations. In 2011 Dr. Pugh received the Presidential Early Career Award for Scientists and Engineers from President Barak Obama at the White House. She is considered to be a lead, international expert on the use of sensors and motion tracking technology for performance measurement. In 2014 she was invited to give a TEDMED talk on the potential uses of technology to transform how we measure clinical skills in medicine. In April 2018, Dr. Pugh was inducted into the American Institute for Medical and Biological Engineering.

Clinical Focus


  • General Surgery

Academic Appointments


Professional Education


  • Fellowship:University of Michigan Medical School (2009) MI
  • Board Certification: General Surgery, American Board of Surgery (1999)
  • Residency:Howard University Hospital General Surgery Residency (1997) DC
  • Medical Education:Howard University College of Medicine (1992) DC

Current Research and Scholarly Interests


The Technology Enabled Clinical Improvement (T.E.C.I.) Center is a multidisciplinary team of researchers dedicated to the design and implementation of advanced engineering technologies that facilitate data acquisition relating to clinical performance.

The T.E.C.I. team has had great success in quantifying physicians’ clinical experiences using sensor, video, and motion tracking technologies. This work has resulted in an information rich database that enables empirical evaluation of clinical excellence and medical decision making.

By leveraging highly specific and objective clinical performance metrics, the T.E.C.I. Center is harnessing the unique opportunity to support peer to peer data sharing and clinical collaborations that can transform the clinical workflow and ultimately benefit healthcare providers.

The T.E.C.I. Center aims to transform human health and welfare through advances in data science and personalized, technology-based performance metrics for healthcare providers.

All Publications


  • Surgical procedural map scoring for decision-making in laparoscopic cholecystectomy. American journal of surgery Hashimoto, D. A., Axelsson, C. G., Jones, C. B., Phitayakorn, R., Petrusa, E., McKinley, S. K., Gee, D., Pugh, C. 2018

    Abstract

    INTRODUCTION: The objective of this study was to determine whether decision-based procedural mapping demonstrates differences in attendings versus residents.METHODS: Attendings and residents were interviewed about operative decision-making in laparoscopic cholecystectomy (LC) using a cognitive task analysis framework. Interviews were converted into procedural maps. Operative steps, patient factors, and surgeon factors noted by attendings and residents were compared. Two scoring methods were used to compare map structures of attendings versus residents.RESULTS: Six attendings and six residents were interviewed. There were no significant differences in the number of patient or surgeon factors identified. Attendings had significantly more operative steps (29.67 ± 1.9 vs. 23.3 ± 1.9, p = 0.04) and crosslinks (3.2 ± 0.5 vs. 1 ± 0.4, p = 0.005) in their maps and a higher total score (90.2 ± 8.4 vs. 63.2 ± 3.8, p = 0.015) than residents.CONCLUSION: LC procedural map scoring for attendings and residents demonstrated significant differences in structural complexity and may provide a useful framework for assessing decision making.

    View details for DOI 10.1016/j.amjsurg.2018.11.011

    View details for PubMedID 30470551

  • Shortcut assessment: Can residents' operative performance be determined in the first five minutes of an operative task? Surgery Mohamadipanah, H., Nathwani, J., Peterson, K., Forsyth, K., Maulson, L., DiMarco, S., Pugh, C. 2018; 163 (6): 1207–12

    Abstract

    BACKGROUND: The aim was to validate the potential use of a single, early procedure, operative task as a predictive metric for overall performance. The authors hypothesized that a shortcut psychomotor assessment would be as informative as a total procedural psychomotor assessment when evaluating laparoscopic ventral hernia repair performance on a simulator.METHODS: Using electromagnetic sensors, hand motion data were collected from 38 surgery residents during a simulated laparoscopic ventral hernia repair procedure. Three time-based phases of the procedure were defined: Early Phase (start time through completion of first anchoring suture), Mid Phase (start time through completion of second anchoring suture), and Total Operative Time. Correlations were calculated comparing time and motion metrics for each phase with the final laparoscopic ventral hernia repair score.RESULTS: Analyses revealed that execution time and motion, for the first anchoring suture, predicted procedural outcomes. Greater execution times and path lengths correlated to lesser laparoscopic ventral hernia repair scores (r = -0.56, P = .0008 and r = -0.51, P = .0025, respectively). Greater bimanual dexterity measures correlated to Greater LVH repair scores (r = + 0.47, P = .0058).CONCLUSIONS: This study provides validity evidence for use of a single, early operative task as a shortcut assessment to predict resident performance during a simulated laparoscopic ventral hernia repair procedure. With the continued development and decreasing costs of motion technology, faculty should be well-versed in the use of motion metrics for performance measurements. The results strongly support the use of dexterity and economy of motion (path length + execution time) metrics as early predictors of operative performance.

    View details for DOI 10.1016/j.surg.2018.02.012

    View details for PubMedID 29728259