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It is essential for surgeons to have their skill evaluated prior to entering the oper- ating room. Most evaluation methods currently in use are subjective, relying on human judgment to assess trainees. Recently, sensors have been used to track the positions of instruments and the forces applied to them by surgeons, opening up the possibility of automated skill analysis. This thesis presents a newly developed recording system, and novel methods used to automatically analyze surgical skill within the context of laparoscopic procedures. The evaluation methods are tested using an empirical study involving a number of participants with a wide range of surgical skill.

The dissertation analyses how to approach teaching of writing skills in Russian language at Czech secondary schools. In the theoretical part I define what a "writing skill" is. I focus on the linguistic, psycholinguistic and didactic aspects of the teaching of writing. I explain attitudes to writing skills in different teaching methods in history and nowadays. After that I set out the requirements for testing writing skills in some of the most common documents: Common European Framework for Languages, European Language Portfolio, international exams in Russian language ТРКИ (Тест русского языка как иностранного) or TORFL (Test of Russian as a Foreign Language) and the state final exam in Russian language at Czech secondary schools. In the practical part, I first analyse selected Czech and Russian textbooks for grammar schools to compare their approach towards teaching writing skills in native languages: Czech and Russian. Then I set out analysis of Czech textbooks used in the Czech Republic for teaching Russian, focusing in particular on the exercises used to teach writing. After that, I evaluate answers from two questionnaires that I gave to secondary school graduates and teachers of Russian. My goal was to understand the issues they face and any problems they experience in practice when learning...

Introduction: During laparoscopic surgery, surgeons may experience prolonged periods without fluid intake, which might impact surgical performance, yet there are no objective data investigating this issue. Therefore, the aim of this study was to elucidate the effect of prolonged dehydration on laparoscopic surgical performance and tissue handling. - Methods: A total of 51 laparoscopic novices participated in a single-center, open-label, prospective randomized cross-over trial. All participants were trained to proficiency using a standardized laparoscopic training curriculum. Afterward, all participants performed four different laparoscopic tasks twice, once after 6 h without liquid intake (dehydrated group) and once without any restrictions (control group). Primary endpoints were tissue handling defined by force exertion, task time, and error rate. The real hydration status was assessed by biological parameters, like heart rate, blood pressure, and blood gas analysis. - Results: 51 laparoscopic novices finished the curriculum and completed the tasks under both hydrated and dehydrated conditions. There were no significant differences in mean non-zero and peak force between the groups. However, dehydrated participants showed significantly slower task times in the Peg transfer task (hydrated: 139.2 s vs. dehydrated: 147.9 s, p = 0.034) and more errors regarding the precision in the laparoscopic suture and knot task (hydrated: 15.7% accuracy rate vs. dehydrated: 41.2% accuracy rate, p < 0.001). - Conclusion: Prolonged periods of dehydration do not appear to have a substantial effect on the fundamental tissue handling skills in terms of force exertion among surgical novices. Nevertheless, the observed impact on speed and precision warrants attention.

Training improves skills in minimally invasive surgery. This study aimed to investigate the learning curves of complex motion parameters for both hands during a standardized training course using a novel measurement tool. An additional focus was placed on the parameters representing surgical safety and precision. Fifty-six laparoscopic novices participated in a training course on the basic skills of minimally invasive surgery based on a modified Fundamentals of Laparoscopic Surgery (FLS) curriculum. Before, twice during, and once after the practical lessons, all participants had to perform four laparoscopic tasks (peg transfer, precision cut, balloon resection, and laparoscopic suture and knot), which were recorded and analyzed using an instrument motion analysis system. Participants significantly improved the time per task for all four tasks (all p < 0.001). The individual instrument path length decreased significantly for the dominant and non-dominant hands in all four tasks. Similarly, both hands became significantly faster in all tasks, with the exception of the non-dominant hand in the precision cut task. In terms of relative idle time, only in the peg transfer task did both hands improve significantly, while in the precision cut task, only the dominant hand performed better. In contrast, the motion volume of both hands combined was reduced in only one task (precision cut, p = 0.01), whereas no significant improvement in the relative time of instruments being out of view was observed. FLS-based skills training increases motion efficiency primarily by increasing speed and reducing idle time and path length. Parameters relevant for surgical safety and precision (motion volume and relative time of instruments being out of view) are minimally affected by short-term training. Consequently, surgical training should also focus on safety and precision-related parameters, and assessment of these parameters should be incorporated into basic skill training accordingly.