{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:53:36Z","timestamp":1792151616901,"version":"4.4.0"},"reference-count":22,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Education"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.jsurg.2026.104073","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:34:25Z","timestamp":1788503665000},"page":"104073","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cSlow Is Smooth, Smooth Is Fast\u201d: Artificial Intelligence-Driven Suturing Simulation for Cardiothoracic Surgical Training"],"prefix":"10.1016","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2710-063X","authenticated-orcid":false,"given":"Sue X.","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2284-6114","authenticated-orcid":false,"given":"Vivian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-192X","authenticated-orcid":false,"given":"Shahab","family":"Masoumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5926-5482","authenticated-orcid":false,"given":"Ali","family":"Homaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Haeng","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5165-3219","authenticated-orcid":false,"given":"Karim","family":"Kohel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Baioumy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf","family":"Sabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3500-897X","authenticated-orcid":false,"given":"Tommaso","family":"Danesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9538-9608","authenticated-orcid":false,"given":"Amy","family":"Hackmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sary","family":"Aranki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Jaklitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger D.","family":"Dias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-0786","authenticated-orcid":false,"given":"M. Blair","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borami","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.jsurg.2026.104073_bib0001","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1016\/j.jtcvs.2012.06.004","article-title":"Simulation for technical skills","volume":"144","author":"Marshall","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"5","key":"10.1016\/j.jsurg.2026.104073_bib0002","doi-asserted-by":"crossref","first-page":"675","DOI":"10.4300\/JGME-D-20-01259.1","article-title":"Factors influencing the entrustment of resident operative autonomy: comparing perceptions of general surgery residents and attending surgeons","volume":"13","author":"Senders","year":"2021","journal-title":"J Grad Med Educ"},{"issue":"9","key":"10.1016\/j.jsurg.2026.104073_bib0003","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.29787","article-title":"Assessment of surgeon performance of advanced open surgical skills using a microskills-based novel curriculum","volume":"5","author":"Greenberg","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"1","key":"10.1016\/j.jsurg.2026.104073_bib0004","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/SLA.0b013e318220ef31","article-title":"Simulator training to automaticity leads to improved skill transfer compared with traditional proficiency-based training: a randomized controlled trial","volume":"255","author":"Stefanidis","year":"2012","journal-title":"Ann Surg"},{"issue":"2","key":"10.1016\/j.jsurg.2026.104073_bib0005","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jsurg.2014.09.005","article-title":"Simulation training improves resident performance in hand-sewn vascular and bowel anastomoses","volume":"72","author":"Egle","year":"2015","journal-title":"J Surg Educ"},{"issue":"1","key":"10.1016\/j.jsurg.2026.104073_bib0006","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.athoracsur.2016.06.062","article-title":"Simulation-based training in cardiac surgery","volume":"103","author":"Feins","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jsurg.2026.104073_bib0007","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.ejvsvf.2022.10.001","article-title":"Objective evaluation of clock face suture using the Objective structured assessment of technical skill (OSATS) checklist","volume":"57","author":"Treil","year":"2022","journal-title":"EJVES Vasc Forum"},{"issue":"15","key":"10.1016\/j.jsurg.2026.104073_bib0008","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1056\/NEJMsa1300625","article-title":"Surgical skill and complication rates after bariatric surgery","volume":"369","author":"Birkmeyer","year":"2013","journal-title":"N Engl J Med"},{"issue":"2","key":"10.1016\/j.jsurg.2026.104073_bib0009","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/SIH.0000000000000477","article-title":"Learning curves in health professions education simulation research: a systematic review","volume":"16","author":"Howard","year":"2021","journal-title":"Sim Healthcare"},{"key":"10.1016\/j.jsurg.2026.104073_bib0010","unstructured":"Feins RH, Burkhart HM, Coore DN, et al. Cardiac Surgery Simulation Curriculum. Available at: http:\/\/www.tsda.org\/wp-content\/uploads\/2016\/01\/Cardiac-Surgery-SimulationCurriculum-TSDA.pdf. Accessed April 1, 2023."},{"issue":"9","key":"10.1016\/j.jsurg.2026.104073_bib0011","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1007\/s11548-018-1771-1","article-title":"Laparoscopic training using a quantitative assessment and instructional system","volume":"13","author":"Yamaguchi","year":"2018","journal-title":"Int J Comput Assist Radiol Surg"},{"issue":"2","key":"10.1016\/j.jsurg.2026.104073_bib0012","first-page":"273","article-title":"Objective structured assessment of technical skill (OSATS) for surgical residents","volume":"84","author":"Martin","year":"1997","journal-title":"Br J Surg"},{"issue":"1","key":"10.1016\/j.jsurg.2026.104073_bib0013","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/SLA.0b013e318220ef31","article-title":"Simulator training to automaticity leads to improved skill transfer compared with traditional proficiency-based training: a randomized controlled trial","volume":"255","author":"Stefanidis","year":"2012","journal-title":"Ann Surg"},{"issue":"7","key":"10.1016\/j.jsurg.2026.104073_bib0014","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1002\/bjs.7115","article-title":"Objective assessment of technical surgical skills","volume":"97","author":"van Hove","year":"2010","journal-title":"Br J Surg"},{"issue":"4","key":"10.1016\/j.jsurg.2026.104073_bib0015","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.surg.2017.11.011","article-title":"Time crunch: increasing the efficiency of assessment of technical surgical skill via brief video clips","volume":"163","author":"Sawyer","year":"2018","journal-title":"Surgery"},{"issue":"7","key":"10.1016\/j.jsurg.2026.104073_bib0016","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1002\/lary.24023","article-title":"Assessment of improvement of trainee surgical skills in the operating room for tonsillectomy","volume":"123","author":"Ahmed","year":"2013","journal-title":"Laryngoscope"},{"issue":"5","key":"10.1016\/j.jsurg.2026.104073_bib0017","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1016\/j.surg.2017.09.002","article-title":"A decade of imaging surgeons' brain function (part II): a systematic review of applications for technical and nontechnical skills assessment","volume":"162","author":"Modi","year":"2017","journal-title":"Surgery"},{"key":"10.1016\/j.jsurg.2026.104073_bib0018","unstructured":"Grandview Research. Surgical Simulation Market Size, Share & Trends Analysis Report. Report No. GVR-4-68039-827-3. Published November 19, 2024. Accessed December 17, 2025. https:\/\/www.grandviewresearch.com\/industry-analysis\/surgical-simulation-market-report."},{"key":"10.1016\/j.jsurg.2026.104073_bib0019","unstructured":"Zheng Ge SL, Feng W, Zeming L, Jian S. YOLOX: exceeding YOLO series in 2021. 2021. DOI: https:\/\/doi.org\/10.48550\/arXiv.2107.08430."},{"issue":"3","key":"10.1016\/j.jsurg.2026.104073_bib0020","doi-asserted-by":"crossref","DOI":"10.1002\/aet2.70072","article-title":"Computer-based competency assessment in point-of-care ultrasound: a systematic review","volume":"9","author":"Allan-Blitz","year":"2025","journal-title":"AEM Educ Train"},{"issue":"6","key":"10.1016\/j.jsurg.2026.104073_bib0021","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1109\/TPAMI.1986.4767851","article-title":"A computational approach to edge detection","volume":"8","author":"Canny","year":"1986","journal-title":"IEEE Trans Pattern Anal Mach Intell"},{"issue":"5","key":"10.1016\/j.jsurg.2026.104073_bib0022","first-page":"1516","article-title":"An improved canny algorithm for edge detection","volume":"7","author":"Zhou","year":"2011","journal-title":"J Comput Inf Syst"}],"container-title":["Journal of Surgical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1931720426002060?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1931720426002060?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:18:51Z","timestamp":1792149531000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1931720426002060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["S1931720426002060"],"URL":"https:\/\/doi.org\/10.1016\/j.jsurg.2026.104073","relation":{},"ISSN":["1931-7204"],"issn-type":[{"value":"1931-7204","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"\u201cSlow Is Smooth, Smooth Is Fast\u201d: Artificial Intelligence-Driven Suturing Simulation for Cardiothoracic Surgical Training","name":"articletitle","label":"Article Title"},{"value":"Journal of Surgical Education","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jsurg.2026.104073","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"104073"}}